Pre-operative and post-operative echocardiographic study in 12 patients with left atrial myxoma

We reviewed the echocardiograms of 12 patients with left atrial myxoma. All 12 patients had pre- and post-operative M-mode echocardiographic study as well as two-dimensional (2-D) echocardiographic study. Five patients had cardiac catheterization and angiographic studies too. M-mode and 2-D echocardiography gave the diagnosis of left atrial tumor in all patients studied by either method. Extraneous echo seen behind the anterior mitral leaflet was present in all 12 cases studied by M-mode echocardiography. Mean left atrial dimension was increased before operation, 44.9 ± 7.7 mm and decreased significantly after operation, 31.8 ± 4.0 mm (p < 0.001). Left ventricular end-diastolic dimension changed from 46.8 ± 6.1 mm (pre-operation) to 43.9 ± 4.3 mm (post-operation) (statistically not significant). The mean EF slope of the anterior mitral leaflet changed from 20.9 ± 12.1 mm/sec (pre-operation) to 108 ± 35.6 mm/sec (post-operation) (p < 0.001). The time gap between the mitral valve opening and the appearance of prolapsing tumor echo was present in all 12 cases. The mean value of this time gap was 0.09 ± 0.02 sec. 2-D echocardiography correctly identified the left atrial tumor in all 12 patients studied. 2-D echocardiography also gave the information regarding the size, motility and the site of insertion of the tumor. Five patients had angiographic study and left atrial tumor was identified in all 5 cases. We concluded that echocardiography, especially 2-D echocardiography is an excellent diagnostic tool for the detection of cardiac tumor. Cardiac catheterization seems unnecessary when the echocardiogram has given the diagnosis of cardiac tumor.