Angiographic and echocardiographic observations in surgical patients with atrial myxoma.

In a series of 18 patients with atrial myxoma (16 left, 2 right) the tumors were consistently identified by right ventriculography and generally visualized by left ventriculography in patients with left atrial myxoma examined owing to concomitant mitral insufficiency caused by tumor invasion at the site of mitral valve closure. Echocardiography was suited to early diagnosis of suggested tumor. Pseudoaneurysms in the cerebral and coronary arteries, apparently caused by myxomatous emboli with weakening of vessel lumen, were noted in several patients; therefore, selective coronary and cerebral arteriography should be performed preoperatively in patients with symptoms of thromboembolism. We stress that echocardiography should be performed routinely after surgery to disclose recurrences, while arteriographic control studies should be added in cases with vascular anomalies seen preoperatively.