Cardiac Myxomas

Two patients with atrial myxomas, one arising in the right and one in the left atrium are presented to illustrate certain diagnostic and surgical features. The changing clinical findings produced by these tumors were brought about by disturbance of mitral and tricuspid valve functions. The clinical picture presented by the patient with a right atrial myxoma resembled that caused by chronic congestive failure, tricuspid valve disease, the carcinoid syndrome or constrictive pericarditis. The patient with the left-sided tumor presented the symptoms and findings of rheumatic mitral stenosis and experienced arterial emboli. The most important finding which pointed to the diagnosis of atrial tumor was the variability and changing nature of the cardiac murmurs. Cardiac catheterization revealed obstruction at the mitral valve in one patient and the tricuspid valve in the other. Cineangiocardiography demonstrated the left atrial tumor but was not performed in the patient with the right atrial tumor. Both tumors were successfully excised using extracorporeal circulation. The pedicle of origin and underlying atrial myocardium were excised in each instance. Invasion of the underlying myocardium was not demonstrated.