PMC6590630_01
2-dimensional transthoracic (TTE) and transesophageal series (TEE). (A) 2D-TTE parasternal long axis view with indicating the prolapsed left atrial myxoma during systole (enveloped by the white, elliptical border). (B) Transesophageal view of the atrial myxoma (subtended by the white curvilinear line). (C) 2D-TTE parasternal long axis view illustrating the pseudo-stenotic, obstructive effect of the atrial myxoma (subtended by the white curvilinear) of both the mitral valve orifice and left ventricular outflow tract. (D) 2D-TTE short axis view of the atrial myxoma at the level of the mitral valve and its subvalvular apparatus (enveloped by the white, elliptical border).
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Initial transthoracic and subsequent transesophageal echocardiography demonstrated a large 42 mmx40 mm mass arising from the left atrium and adherent to the inter-atrial septum (see Figure 1A and B).
Cineangiography series. (A) Left coronary angiography revealing patent left anterior descending and left circumflex arteries (indicated by the black arrows) with thrombolysis in myocardial infarction (TIMI 3) antegrade flow. (B) Right coronary angiography revealing a dominant and patent right coronary with TIMI 3 antegrade flow (indicated by the black arrow).
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D). Diagnostic coronary angiography demonstrated mild, non-obstructive coronary artery disease with thrombolysis in myocardial infarction (TIMI) 3 antegrade flow (see Figure 2A and B).
Resected gross specimen. Histopathology examination of the specimen confirmed the diagnosis of myxoma.
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The mass suspected to be a myxoma was excised by resecting the pedicle implanted on the interatrial septum (Figure 3).