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(Chest. 1995;107:674-679.)
© 1995 American College of Chest Physicians

Left Atrial Myxomas

Using Gross Anatomic Tumor Types to Determine Clinical Features and Coronary Angiographic Findings

Takatsugu Shimono MD1; Shigeyuki Makino MD1; Yuo Kanamori MD1; Toshihiko Kinoshita MD1; and Isao Yada MD1

1 From the Department of Thoracic and Cardiovascular Surgery, Mie University, School of Medicine, Tsu, Japan

Purpose: To our knowledge, there have been no reports focusing on differences of clinical characteristics according to two gross anatomic types of cardiac myxomas. This study evaluated the differences of clinical features, coronary arteriographic findings, and histopathologic findings.

Patients and methods: Twenty-six patients who underwent surgical excisions for left atrial myxomas were analyzed. According to the gross anatomic types, they were divided into two groups: group 1 having solid and ovoid myxomas (n=14), and group 2 having soft and papillary myxomas (n=12). Differences of presenting symptoms, prevalence of brain infarction, coronary angiographic findings, and histopathologic findings were analyzed.

Results: An incidence of dyspnea was significantly higher in group 1 (78.6% 7o vs 33.3%, p<0.05) than in group 2. That of neurologic symptoms was higher in group 2 (75% vs 14.3%, p<0.01) than in group 1. A prevalence of brain infarction was higher in group 2 (75% vs 2.5%, p<0.05) than in group 1. On coronary angiography, an identification rate of clusters of tortuous vessels was higher in group 1 (81.8% vs 0% 0, p<0.01) than in group 2. In histologic findings, most of group 1 tumors displayed many hemorrhages, small vessels, and fibrosis in the stroma, but group 2 had few such structures.

Conclusions: Coronary angiographic findings of tumor-feeding arteries without clusters of tortuous tumor vessels predict a myxoma that is papillary in type. At that time, close attention should be given for the possible existence of silent brain infarction.

Key Words: brain infarction • cardiac myxoma • clinical characteristics • coronary angiography • gross anatomic type • histopathologic finding

Submitted on April 8, 1994
Accepted on June 23, 2007




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