[A successful operation for left atrial myxoma and mitral valve regurgitation with giant LA]

A 78-year-old woman was introduced to our clinic, complaining of orthopnea and severe appetite loss, and her performance status was evaluated as NYHA IV. Computed tomogram revealed a myxoma in left atrium (LA) as a low density area and MRI demonstrated a high intensity shadow. Left ventriculogram and color Doppler echocardiogram showed severe mitral valve regurgitation (MR) with giant LA. LA myxoma was completely resected through both LA-tomy and RA-tomy. The LA was plicated according to the method reported by Kawazoe, followed by a mitral valve replacement with SJM 25 mm, and a tricuspid annuloplasty according to the DeVega's method. The postoperative course was uneventful and her performance status improved to NYHA II at discharge. LA myxoma frequently causes secondary MR. In this case, however, the LA myxoma did not affect the function of mitral valve, judging from its size and position. There were a few reports about LA myxoma complicated with primary MR. We also confirmed that a LA plication was very useful for the treatment of giant LA to improve a respiratory failure.