Nagatomi Shuji, Matsumoto Kazuhisa, Tateishi Naoki, Toyokawa Kenji, Mukaihara Kosuke, Soga Yoshiharu
Department of Cardiovascular Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
J Surg Case Rep. 2022 May 5;2022(5):rjac208. doi: 10.1093/jscr/rjac208. eCollection 2022 May.
Cardiac myxoma is a benign primary cardiac tumor. Herein, we report a case of mitral regurgitation due to annular dilatation caused by giant left atrial myxoma. The transthoracic echocardiogram performed in a 65-year-old man who suffered from worsening exertional dyspnea detected a large mass of 81 × 31 mm in the left atrium, causing functional severe mitral stenosis. Radical mass resection was performed. After removal of the aortic clamp, an intraoperative transesophageal echocardiogram revealed moderate mitral regurgitation due to annulus dilatation. Mitral annuloplasty was performed, and mitral regurgitation was controlled. The mass was diagnosed as myxoma histologically. A large myxoma that affects mitral annulus dilatation is rarely reported. Mitral regurgitation may be masked by the presence of a large myxoma. Therefore, it should be carefully evaluated after resection, and mitral annuloplasty should be considered in the presence of significant mitral regurgitation due to mechanical annulus dilatation caused by myxoma.
心脏黏液瘤是一种原发性心脏良性肿瘤。在此，我们报告一例因巨大左心房黏液瘤导致瓣环扩张引起二尖瓣反流的病例。一名65岁男性因劳力性呼吸困难加重接受经胸超声心动图检查，发现左心房有一个81×31mm的大肿块，导致功能性严重二尖瓣狭窄。进行了根治性肿块切除术。移除主动脉夹后，术中经食管超声心动图显示由于瓣环扩张导致中度二尖瓣反流。进行了二尖瓣瓣环成形术，二尖瓣反流得到控制。该肿块经组织学诊断为黏液瘤。影响二尖瓣瓣环扩张的大黏液瘤鲜有报道。大黏液瘤的存在可能掩盖二尖瓣反流。因此，切除后应仔细评估，对于因黏液瘤导致机械性瓣环扩张引起的显著二尖瓣反流，应考虑进行二尖瓣瓣环成形术。
