A 49-year-old male, known case of hypertension, hyperlipidemia and diabetes mellitus, presented with history of unstable angina. Transthoracic echocardiogram showed left atrial myxoma. His coronary angiogram showed critical left main stenosis with triple vessel disease. There was total occlusion of LAD and first diagonal 1. He was referred for an emergency cardiac surgery.

Surgical Procedure

Under cardiopulmonary bypass and cardioplegic arrest, left atrial myxoma was excised and removed in toto through biatrial approach. Left atrial myxoma was 7 cm x 3 cm in size. Atrial septum was directly closed. He also had CABG x4 where left IMA was anastomosed to mid LAD and SVG was anastomosed to first diagonal, OM2 and PDA. The patient came off bypass with stable hemodynamics. .

Conclusion

Atrial myxomas are the most benign primary tumors of the heart with a majority arising in the left atrium. Approximately 10 to 15% of patients with atrial myxo-mas may be completely asymptomatic. Most often a thorough preoperative evaluation detects the underlying pathology in these patients.

This particular patient was having predominantly symptoms of ischemic heart disease. Routine cardiology evaluation with transthoracic echocardiogram detected the presence of a left atrial mass. This patient had successful removal of left atrial myxoma and coronary bypass surgery.

Cardiac myxoma and ischemic heart disease left atrial myxoma and CABG - Burjeel