[Myxoma of the left atrium and advanced renal failure]

A 34 years old woman with a history of childhood rheumatic fever presented with a number of episodes of systemic embolism over a 10 years period attributed to mitral stenosis despite long-term anticoagulant therapy. All preoperative electrocardiograms showed sinus rhythm. After one episode of recurrent embolism (brain, limbs) requiring femoral embolectomy, she developed oligo-anuric renal failure and needed 21 days of hemodialysis. She made a full recovery. Several years later, she presented with chronic progressive renal failure. The diagnosis of left atrial myxoma was eventually made at echocardiography: surgical excision was successful. Periodic hemodialysis was started six months later. The authors use this case to illustrate unusual presentations of myxoma and above all their vascular complications; the possibility of embolic renal disease leading to advanced renal failure is discussed, a complication of left atrial myxoma which seems to be very rare.