Giant fibrocalcific left atrial myxoma causing mitral insufficiency and congestive cardiac failure

Abstract

Myxomas are the commonest primary benign cardiac tumors. Approximately 75 % of these tumors arise from the left atrium and 18–20 % from the right atrium. Left atrial myxomas usually present with features of mitral stenosis and occasionally with distal embolism, bacterial endocarditis, or constitutional symptoms. Mitral insufficiency is a rare presenting feature. They are most frequently soft and friable without microscopic signs of calcification. We report a case of giant fibrocalcific left atrial myxoma causing moderate-to-severe mitral regurgitation and presenting as a congestive cardiac failure in a 49-year-old female. The diagnosis was made by transthoracic echocardiography and cineangiography. She underwent successful removal of the left atrial myxoma with repair of mitral valve using annuloplasty ring. Postoperative course was stormy, but the recovery was complete and postoperative echocardiography revealed no residual myxoma and only mild mitral regurgitation.