[Contribution of transesophageal echocardiography in the assessment of cardiac myxomas].

INTRODUCTION AND OBJECTIVES

Transthoracic echocardiography is the gold-standard method in the diagnosis of cardiac myxomas. Our aim was to analyze the usefulness of transesophageal echocardiography in the diagnosis and assessment of patients with cardiac myxomas.

PATIENTS AND METHODS

From 1990 to 1992, 14 patients underwent cardiac surgery with the echocardiographic diagnosis (transthoracic and/or transesophageal approach) of cardiac myxomas. Thirteen (86%) of the 14 patients had after surgery histological confirmation of myxoma. Of the 13 myxomas, 10 were located in the left atrium and 3 in the right atrium.

RESULTS

Transthoracic echocardiography was able to diagnose the presence of myxoma in 12 of the 13 patients, whereas the transesophageal approach detected all of them. The precise attaching point of the tumour was seen in 9 patients with transthoracic echocardiography and in all the patients with the transesophageal approach. Also the presence of satellite tumours seen in 2 patients was only detected by transesophageal echocardiography.

CONCLUSION

We conclude that the sensitivity in the diagnosis of cardiac myxomas is similar with both techniques, but transesophageal echocardiography is much more accurate in the detection of the precise attaching point and the presence of satellite tumours. We think that TEE is a useful tool, complementary to TTE, in the assessment of patients with cardiac myxomas before going to surgery.