A case of unusually located left ventricular myxoma: myxoma attached to the chordae tendinea of the mitral valve

摘要

A 32-year-old male patient was admitted to our clinic with complaints of exertional chest pain and shortness of breath. His blood pressure was 120/70 mmHg and his heart rate was 80 bpm. In the physical examination, Grade II/IV mid-diastolic murmur was noted at the car- diac apex with a harsh S1. His electrocardiogram was within normal limits. In transthoracic echocardiography, a mobile, heterogeneous mass was seen with a stalk in the left ventricle attached to the mitral valve (Fig. 1). For further evaluation, transesophageal echocardiography was performed. A 1.5 9 3.2-cm mass, attached to the chordae tendinea of mitral the valve with a thin pedicle, was observed (Fig. 2). Because the patient had a strong family history of coronary artery disease, he underwent coronary angiography, which revealed normal coronary arteries. Surgery was scheduled for the removal of the mass. The patient underwent median sternotomy and cardiopulmo- nary bypass under general anesthesia. A gelatinous, pol- ypoid, and lobulated mass attached to the chordae tendinea of the mitral valve posterior leaflet was observed and resected carefully, preserving the mitral valve struc- ture. The postoperational echocardiography revealed a mild mitral regurgitation with no residual mass. Histo- pathological examination confirmed the diagnosis of myxoma. In the following third and sixth months, control transthoracic echocardiography was performed and eval- uated as normal. Annual echocardiographic examination was scheduled for follow up.