Rare cause of dyspnoea: pulmonary artery myxoma

Pulmonary valvular and pulmonary arterial myxomas

“…The electrocardiographic results were reported in 13 (59.1%) patients: normal sinus rhythm in 2 (15.4%) [3,5], Expected cumulative probabilities atypical atrioventricular rhythm without evidence of myocardial infarction in 1 (7.7%) [6], sinus tachycardia in 1 (7.7%) [16], right ventricular hypertrophy in 3 (23.1%) [9][10][11], right bundle branch block with peaked P wave in 2 (15.4%) [7,21], complete atrioventricular block in 1 (7.7%) [17], pacing rhythm and ST-T changes (7.7%) [14], and atrial fi brillation in 2 (15.4%) patients [13,15]. Chest X-ray fi lms were taken in 6 (27.3%) patients: normal in 2 (33.3%) [5,11], right heart enlargement in 2 (33.3%) [7,21], pulmonary congestion with enlarged cardiac silhouette in 1 (16.7%) [16] and decreased lung textures with prominent pulmonary arter y segment in 1 (16.7%) patient [19]. A chest CT was examined in 3 patients: showing a fi lling def ect in the main pulmonar y artery and (or) right ventricular outfl ow tract (RVOT) in all [9,10,23].…”

“…Computed tomography angiography was done in 2 (11.1%) patients with fi lling defects found in both [12,15]. Magnetic resonance imaging w as examined in 2 (9.1%) patients, and it showed a solid mass in the pulmonary artery trunk in both [5,18]. Perfusion scan showed absence of left lung perfusion in 1 (4.5%) patient [10].…”

“…The myxoma was arising from the pulmonary valve in 12 (54.5%) [4,7,8,11,12,14,[17][18][19]21,22,24], from the pulmonary artery in 9 (40.0%) [3,5,9,10,13,15,16,20,23], and from pulmonary valve and pulmonary artery in 1 (4.5%) patient [6]. In one patient, there were two myxomas arising from the pulmonary artery [20].…”

“…The diagnostic methods depended on preoperative m edical imaging in most cases, while the diagnosis was made by surgical ex ploration in 3 (18.8%) [7,9,21], and by autopsy in 2 (9.1%) patients [6,13]. The dimension of the myxomas was 2.5 ± 1.2 (range, 1-5; median, 3) cm (n =19) [3][4][5][8][9][10][13][14][15][17][18][19][20][21][22]24]. There was no signifi cant difference between the dimensions of pulmonary valve and pulmonary artery (2.4 ± 1.0 cm vs. 3.1 ± 1.2 cm, p = 0.175).…”

“…Cardiopulmonary bypass technique was mentioned in 13 (59.1%) reports: a conventional hypothermic cardiopulmonary bypass technique was used in 11 (84.6%) [4,[7][8][9]11,12,[14][15][16][17]19], a normothermic cardiopul monary bypass with beating heart in 1 (7.7%) [18], and deep hypothermic circulatory arrest in 1 (7.7%) patient [21]. Apart from the two patients who had a sudden death, all remaining patients underwent a surgical operation: 19 (95%) pat ients had a pulmonary myxoma resection (operation unspecifi ed in 4 [21.1%] [4,20,23,24], a sole myxoma resection in 5 (26.3%) [5,10,11,18,19], with concurrent pulmonary valve leafl et resection plus dilation of pulmonary valvular ring in 2 (10.5%) [7,21], with concurrent pulmonary valve leafl et resection in 1 (5.3%) [17], with concurrent reco nstruction of th e pulmonary artery trunk and RVOT in 2 (10.5%) [8,12], with concurrent pulmonar y valve replaceme nt in 1 (5.3%) [22], with concurrent aortic valve repl acement and tricuspid valve repair in 1 (5.3%) patient [15] and with ductal ligation in 1 (5.3%) [16], and with one-stage myocardial bridging resection in 1 (5.3%) [14 ], and 1 (5%) patient underwent thromboembolectomy [9]. Diagnosis of myx oma was proved by histology in all patients.…”