Role of Coronary Angiography in Myxoma Patients: A 14-Year Experience in One Medical Center

Li, Ai-Hsien; Liau, Chiau‐Suong; Wu, Chau‐Chung; Chien, Kuo‐Liong; Ho, Yi-Lwun; Huang, Chieng-Hua; Chen, Ming-Fong; Lee, Yuan‐Teh

doi:10.1159/000006979

Cited by 21 publications

(20 citation statements)

References 17 publications

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“…Some previous publications showed a prevalence of coronary artery disease between 0 and 11% in patients with myxoma 2 . However, two recent studies showed values between 20.3 and 36.6%, more compatible with the age range of these patients for whom a higher percentage of risk factors for atherosclerosis such as systemic hypertension and dyslipidemia is observed 1,2 .…”

Section: Discussionsupporting

confidence: 54%

“…Some authors support the idea that all patients should undergo cardiac surgery as soon as the diagnosis is made, without previous angiographic examination, basing this assumption on the risk of sudden death 2,4,5 . Others consider coronary angiography a mandatory test only for patients with anginal symptoms or over forty years of age 1,2,4 .…”

Section: Discussionmentioning

confidence: 99%

“…Others consider coronary angiography a mandatory test only for patients with anginal symptoms or over forty years of age 1,2,4 . Venticulography is another controversial aspect because of the potential risk of embolization of tumor fragments from the atrium into the left ventricle 2,4,5 .…”

Section: Discussionmentioning

confidence: 99%

“…The most common symptoms include dyspnea, atypical chest pain, and obstructive and embolic phenomena. Cases of sudden death have already been described, probably related to embolization to the coronary circulation 2 . Concomitant presence of coronary artery disease has been rarely described.…”

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Mixoma em átrio esquerdo associado a doença arterial coronariana obstrutiva

Gismondi¹,

Kaufman²,

Correa³

et al. 2007

Arq. Bras. Cardiol.

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Myxoma; heart atria left; coronary disease. block, left anterior hemiblock, and secondary alterations of ventricular repolarization. Chest radiography showed lung hyperinflation and a normal cardiac silhouette. Transesophageal echocardiography showed a 4.7 x 1.7-cm mobile mass in the left atrium that was non-obstructive at Doppler. Its origin could not be visualized, but there seemed to be a pedicle originated in the right upper pulmonary vein (Fig. 1).Myxomas are the most common type of cardiac tumors, accounting for 50% to 60% of the total in some case series, with an estimated incidence between 0.5 and one case per one million inhabitants-year 1 . The most common symptoms include dyspnea, atypical chest pain, and obstructive and embolic phenomena. Cases of sudden death have already been described, probably related to embolization to the coronary circulation 2 . Concomitant presence of coronary artery disease has been rarely described. The objective of this study is to report the case of a patient with left atrial myxoma and obstructive coronary lesions indicating the need of a coronary artery bypass grafting. Case ReportSixty-seven-year-old male patient with hypertension, dyslipidemia, chronic obstructive pulmonary disease and past history of smoking and acute myocardial infarction in 2000, treated with angioplasty without stenting of the anterior descending and right coronary arteries at the time. During preoperative assessment for an inguinal hernia repair, he underwent a transthoracic echocardiography that evidenced a tumor mass in the left atrium compatible with myxoma, and was referred to our institution for therapeutic management.In the initial assessment, the patient was asymptomatic, with a normal physical examination. Electrocardiogram showed a sinus rhythm with complete left bundle branchWe describe the case of a 67-year-old male patient with obstructive coronary artery disease who, in the preoperative assessment for an inguinal hernia repair, had undergone an echocardiography that showed a large, mobile, nonobstructive tumor in the left atrium, with a pedicle originated in the right superior pulmonary vein. The patient underwent a coronary angiography with left ventriculography that showed severe stenosis in the mid-third of the left anterior descending artery, moderate stenosis in the proximal third of the circumflex artery at the origin of the first marginal branch, and a non-obstructive lesion in the distal third of the right coronary artery. Moderate left ventricular dysfunction was also observed. The patient then underwent resection of the tumor and coronary artery bypass grafting. The histopathological examination revealed a myxoma. Considering the past history of infarction and the patient's age, we decided to perform a preoperative coronary angiography that showed no lesions in the trunk, a severe lesion at the mid-third of the anterior descending artery, a moderate lesion in the circumflex artery at the origin of the first marginal branch, albeit with a thin irregular distal bed, and a non...

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Mixoma em átrio esquerdo associado a doença arterial coronariana obstrutiva

Gismondi¹,

Kaufman²,

Correa³

et al. 2007

Arq. Bras. Cardiol.

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“…Dear Sir, I read with interest the recent article on the role of coronary arteriography in myxoma patients by Li et al [1]. Besides detecting and quantifying the severity of coexisting coronary artery disease, selective coronary arteriography is also useful in diagnosing cardiac myxoma per se.…”

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Role of Selective Coronary Arteriography in Patients with Cardiac Myxoma

Cheng¹

2000

Cardiology

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Value of Coronary Angiography in the Cardiac Myxoma

Lee

Jung

et al. 2019

Clinical Anatomy

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Preoperative coronary angiography for cardiac myxoma not only excludes coronary artery disease but also detects the artery feeding the cardiac myxoma, which has several clinical implications. In this study, we examined cardiac myxoma cases in two tertiary hospitals using coronary angiography to identify the artery feeding the myxoma. We retrospectively reviewed 42 patients with cardiac myxoma who had undergone surgical removal between July 2008 and December 2015 in two tertiary hospitals, and recorded their baseline characteristics, echocardiographic findings, and coronary angiography. Among those 42 patients, 23 (55%) had coronary angiography before surgery and in no case was significant luminal narrowing observed. In 21 of the coronary angiograms, the artery feeding the cardiac myxoma had a vascular branch (100%), clusters of tortuous vessels with contrast medium pooling (67%), an arteriocavity fistula (33%), and a mobile feeding artery (67%). No significant relationship was found between coronary artery dominance type and the origin of the artery feeding the cardiac myxoma (P = 0.362). Identification of the artery feeding the cardiac myxoma, with a distinctive vascular appearance in coronary angiography, is important for several clinical applications such as helping to diagnose cardiac myxoma and to plan the surgical approach. Clin. Anat. 33:833–838, 2020. © 2019 Wiley Periodicals, Inc.

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Role of Coronary Angiography in Myxoma Patients: A 14-Year Experience in One Medical Center

Cited by 21 publications

References 17 publications

Mixoma em átrio esquerdo associado a doença arterial coronariana obstrutiva

Mixoma em átrio esquerdo associado a doença arterial coronariana obstrutiva

Role of Selective Coronary Arteriography in Patients with Cardiac Myxoma

Value of Coronary Angiography in the Cardiac Myxoma

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