[Mitral valve repair in a patient with giant left atrial myxoma;report of a case]

Abstract

In patients with left atrial myxoma, mitral valve regurgitation is often encountered. However, preoperative assessment of the mitral valve is difficult in cases with giant left atrial myxoma occupying the left atrial cavity. We experienced a patient with giant left atrial myxoma who underwent tumor excision and mitral valve repair. A 40-year-old woman was transferred to the emergency room due to respiratory failure. On admission, her hemodynamic status was unstable and percutaneous cardiopulmonary support was immediately started. Transesophageal echocardiography was performed, which showed giant left atrial tumor with the pedicle on the atrial septum with mitral valve regurgitation, but the severity of regurgitation was unclear. After excision of left atrial myxoma with atrial septum, the mitral valve was examined. The anterior leaflet( A3 scallop) prolapse due to a torn chordae was found. The mitral valve was repaired with leaflet resection and prosthetic ring annuloplasty. Postoperative course was uneventful and postoperative echocardiography showed no residual mitral valve regurgitation. The mitral valve should be carefully inspected intraoperatively after resection of left atrial myxoma, especially when the tumor is gigantic.