Left atrial myxomas. Using gross anatomic tumor types to determine clinical features and coronary angiographic findings.
OBJECTIVE
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.


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% 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%, 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.
Shimono
T
T
Department of Thoracic and Cardiovascular Surgery, Mie University, School of Medicine, Tsu, Japan.
Makino
S
S
Kanamori
Y
Y
Kinoshita
T
T
Yada
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D002544:Cerebral Infarction / Q000150:complications; D017023:Coronary Angiography; D005260:Female; D006325:Heart Atria; D006338:Heart Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies