Alvarez del Puerto H, Lee H, Sasse L, Levinson I, Sklar H, Steiner L E, Vela J E
Arch Inst Cardiol Mex. 1978 May-Jun;48(3):667-9.
We have been able to differentiate the right pre-operatory diagnosis of mixoma in the left auricle versus "tumor" caused by hypertrophy and fusion of the papillary muscles of the left ventricle in a severe mitral stenosis. In the mixoma we find the echoes only in the ventricular diastole and not in the sistole; there is a place without echoes in the protodiastole--which has a diagnosis value, and sometimes in the telediastole. When it is a "tumor" in the fusioned papillary muscles of the left ventricle, echoes can be found in ventricular diastole and sistole and there are not spaces without echoes in the protodiastole as it is usual in the pedicled tumors of the left auricle. We have found a new sign to predict the existence of a tumor in the left auricle instead of a mitral stenosis; if we find echoes in the left auricle during the ventricular sistole, we will observe that the front edges of the waves form a capital W, and the back ones form a small w. In the central portions of both ws, the waves go forward as it should happen in the mitral valve when existing a real mitral stenosis. Nevertheless, as this central portion is surrounded by a space without echoes, it means that the tumor is a pedicled one, constitutes an obstruction and is causing similar signs to those pertaining to the mitral stenosis.
我们已经能够鉴别出左心房黏液瘤与严重二尖瓣狭窄时左心室乳头肌肥大和融合所导致的“肿瘤”的术前正确诊断。在黏液瘤中，我们仅在心室舒张期而非收缩期发现回声；在舒张前期有一个无回声区——这具有诊断价值，有时在舒张末期也有。当是左心室融合乳头肌中的“肿瘤”时，在心室舒张期和收缩期均可发现回声，且在舒张前期不像左心房带蒂肿瘤那样存在无回声间隙。我们发现了一个新的征象来预测左心房存在肿瘤而非二尖瓣狭窄；如果我们在心室收缩期在左心房发现回声，我们会观察到波的前沿形成一个大写的W，而后沿形成一个小写的w。在两个w的中心部分，波向前行进，就如同存在真正的二尖瓣狭窄时二尖瓣的情况一样。然而，由于这个中心部分被一个无回声间隙所包围，这意味着肿瘤是带蒂的，构成梗阻，并导致与二尖瓣狭窄相关的类似征象。
