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Value of Coronary Angiography in the Cardiac Myxoma

Soo Yong Lee1, Sang Hyun Lee1, Soon Myung Jung1

  • 1Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.

Clinical Anatomy (New York, N.Y.)
|November 22, 2019
PubMed

Insights

Coronary angiography in cardiac myxoma patients can identify the feeding artery, aiding diagnosis and surgical planning. This imaging technique also effectively excludes coronary artery disease in these cases.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Cardiac myxomas are primary heart tumors with variable clinical presentations.
  • Preoperative assessment is crucial for surgical planning and risk stratification.
  • Coronary angiography is typically used to rule out coronary artery disease.

Purpose of the Study:

  • To evaluate the utility of preoperative coronary angiography in identifying the artery supplying cardiac myxomas.
  • To assess the angiographic characteristics of the feeding artery in cardiac myxoma.
  • To determine if coronary angiography can aid in surgical planning for cardiac myxoma removal.

Main Methods:

  • Retrospective review of 42 patients with cardiac myxoma who underwent surgical removal.
  • Analysis of baseline characteristics, echocardiographic findings, and coronary angiograms.
  • Identification and characterization of the artery feeding the cardiac myxoma on coronary angiography.

Main Results:

  • Coronary angiography was performed in 23 (55%) patients preoperatively; no significant coronary artery disease was observed.
  • The artery feeding the cardiac myxoma demonstrated specific angiographic features in 21 cases, including vascular branches (100%), tortuous vessels with contrast pooling (67%), arteriocavity fistula (33%), and a mobile feeding artery (67%).
  • No significant relationship was found between coronary artery dominance and the origin of the feeding artery.

Conclusions:

  • Preoperative coronary angiography is valuable for identifying the specific artery supplying cardiac myxomas.
  • Distinctive angiographic findings of the feeding artery can aid in the diagnosis and surgical approach for cardiac myxoma.
  • Coronary angiography serves a dual role in preoperative assessment: excluding coronary artery disease and characterizing the myxoma's vascular supply.

Keywords:
cardiac myxomacoronary angiographymyxoma removal operation

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