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A 68-YEAR-OLD WOMAN was admitted to the authors’ institution complaining of shortness
of breath and chest pain. Her workup demonstrated a large (5 cm×5 cm) atrial mass
by transthoracic echocardiography. She subsequently was scheduled for resection. On
the day of surgery, transesophageal echocardiography confirmed the presence of this
large, pedunculated left atrial mass, which originated from the interatrial septum
just proximal to the orifice of the right superior pulmonary vein. Its visual appearance
resembled that of a myxoma. The rest of the transesophageal echocardiography (TEE)
examination was unremarkable (Fig 1 and Video 1). The atrial mass was resected completely, including a 1.5 cm×2 cm segment of the
interatrial septum, consistent with the attachment site of the tumor. This defect
in the interatrial septum was reconstructed with a pericardial patch. The atrium was
closed and the patient successfully weaned off cardiopulmonary bypass. Immediately
after cardiopulmonary bypass, repeat TEE found a small mass in the left atrium (Fig 2, Fig 3; Appendix A, Appendix A). What is the diagnosis?
Fig 1Midesophageal four-chamber view showing the large left atrial myxoma.
