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[Surgical treatment of left atrial myxoma with coronary arterial lesion]
1Division of Cardiovascular Surgery, Hyogo Brain and Heart Center, Himeji, Japan.
Insights
Left atrial myxoma can cause coronary arterial lesions, mimicking myocardial infarction. Surgical removal of the myxoma is crucial for patients with coronary artery disease and atrial myxoma.
Area of Science:
- Cardiology
- Cardiac Surgery
- Oncology
Background:
- Left atrial myxoma is a rare primary cardiac tumor.
- Coronary arterial lesions can present as a complication of left atrial myxoma.
Observation:
- Two patients presented with left atrial myxoma and concurrent coronary arterial lesions.
- One patient had acute myocardial infarction due to a non-atherosclerotic coronary stenosis caused by the myxoma.
- The second patient had atherosclerotic coronary artery disease alongside the left atrial myxoma.
Findings:
- Emergency myxoma removal was performed in the patient with acute myocardial infarction.
- Simultaneous myxoma removal and coronary artery bypass grafting were performed in the second patient.
- Both patients had favorable postoperative outcomes with no recurrence.
Implications:
- This case series highlights the importance of considering left atrial myxoma in patients with unexplained coronary arterial lesions.
- Prompt surgical intervention for left atrial myxoma is essential for managing associated coronary artery disease and improving patient outcomes.
- Further research into the pathophysiology of myxoma-induced coronary lesions is warranted.
Abstract:
We experienced two patients of left atrial myxoma with coronary arterial lesion. One patient, who was a 52-year-old female, was transferred to our institute with the diagnosis of acute myocardial infarction. The coronary angiogram showed an abrupt 99% stenosis of posterolateral branch of circumflex artery with no atherosclerotic lesion, and the echocardiography revealed a left atrial myxoma disturbing the blood flow across the mitral valve. She was in congestive heart failure with pulmonary hypertension, and underwent an emergency removal of the myxoma under cardiopulmonary bypass. Another patient, who was a 70-year-old male, was admitted to our institute with the chief complaint of chest pain. The coronary angiogram showed an 75% atherosclerotic stenosis of the right coronary artery, and the echocardiography revealed the left atrial myxoma. He received a removal of myxoma and a coronary artery bypass grafting simultaneously. These 2 patients went a good postoperative course and live a lively life with no local recurrence. In this paper, the surgical treatment of left atrial myxoma with coronary arterial lesion was reviewed.