Coronary angiography of cardiac myxoma.
BACKGROUND
Myxoma usually presents with nonspecific symptoms. Preoperative coronary angiography is presently only considered if patients are at increased risk of coronary artery disease (CAD). The angiographic patterns of cardiac myxoma have not been fully described.


OBJECTIVE
The aim of our study was to investigate coronary angiograms as well as patterns of tumor vascularity in patients with cardiac myxoma.


METHODS
From January 1990 to December 2003, 33 patients with cardiac myxoma, who had received surgical resection at our hospital, were enrolled; of these, 9 patients underwent preoperative coronary angiography. The severity and extent of coronary artery stenosis, as well as tumor angiographic patterns, were analyzed. Coronary artery disease is defined as a > 50% stenosis in diameter at any segment of the coronary artery viewed by two orthogonal views on cineangiogram.


RESULTS
Four (44.4%) patients showed concomitant CAD. The presence of coronary risk factors was not different between patients with and without CAD. Contrast media-enhanced tumor vasculature was found in five (55.6%) patients. Four (80%) patients had multiple feeding arteries. There was the characteristic "sea anemone" appearance of the tumor vasculature composed of (1) basal vascular network, (2) vessel stem, (3) backbone branches, and (4) dye brushes. These findings were characteristic of cardiac myxoma.


CONCLUSIONS
Coronary angiography can detect the concomitant coronary disease and the unique vascular appearances of cardiac myxoma. Familiarity with the "sea-anemone" angiographic findings may help in the diagnosis of cardiac myxoma.
Huang
Chun-Yao
CY
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
Yu
Wen-Chung
WC
Chen
Kuan-Chun
KC
Lin
Shing-Jong
SJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006338:Heart Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D011300:Preoperative Care; D012720:Severity of Illness Index; D016896:Treatment Outcome