Case report

DOI: http://doi.org/10.31928/2305-3127-2020.1.2432 

Features of clinical course, diagnostics and surgical treatment of a giant left atrial myxoma with subsequent mitral valve insufficiency

R.M. Vitovskyi ^1,2, V.P. Zakharova ², I.V. Martyshchenko ², M.O. Tregubova ², V.V. Isaenko ^1,2, A.V. Kupchinsky ²

¹ Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
² M.M. Amosov National Institute of Cardiovascular Surgery of NAMS of Ukraine, Kyiv, Ukraine

Concurrent valvular pathology is a complication of cardiac myxoma leading to hemodynamic disturbances and difficulties in differential diagnostics. Treatment of concurrent valvular pathology should be referred to the concept of hemodynamic radicality of a surgical treatment of cardiac tumors. This paper describes a clinical case of giant left atrial myxoma with mitral valve involvement and coexisting coronary artery disease. Damaged mitral valve anterior cusp with mitral regurgitation was discovered only during surgery after the myxoma had been removed. The condition hasn’t been recognized at transesophageal echocardiography or computed tomography. Undoubtedly, mitral valve regurgitation and cusp damage were tricky to determine due to large size of the tumor and its proximity to the damaged cusp. Moreover, the tumor mass held the damaged cusp in place preventing the development of severe regurgitation.

Key words: left atrial myxoma, mitral regurgitation, coronary artery bypass grafting.