Mitral valve myxomas: an unusual entity
1 Echocardiography Laboratory, Cardiology Department, Santa Marta Hospital, Lisbon, Portugal
2 Internal Medicine Department, São José Hospital, Lisbon, Portugal
3 Cardio-thoracic Surgery Department, Santa Marta Hospital, Lisbon, Portugal
4 Pathology Department, Santa Marta Hospital, Lisbon, Portugal
Received 14 June 2007; accepted after revision 29 July 2007.
* Corresponding author. 30, 1600-645 Lisbon, Portugal. Tel: +351 21 7520045. E-mail address: ricardogil{at}netcabo.pt
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Abstract |
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Primary tumours of the heart are uncommon entities, cardiac myxomas being the most frequent. However, mitral valve myxomas are exceptionally rare. In the last 12 years, there have been 25 myxomas diagnosed at our institution, with only two of them originating from the mitral valve. Both patients were female, the first, 25, and the second, 72 years old. The younger patient was very symptomatic with a large mass, 4 cm long, which involved both leaflets causing significant obstruction to the left ventricular inflow. The second one had a smaller mass located at the atrial side of the posterior leaflet that only produced some flow divergence. Neither of them had constitutional nor embolic symptoms. Both patients were submitted to emergent surgical resection that in the first case involved the mitral valve and replacement with mechanical prosthesis. The macroscopic appearance of these tumours suggested a malignant aetiology which may represent somewhat different features of the myxomas when originating from the cardiac valves. Both patients are well reflecting the good prognosis of this illness after resection, although the younger patient was re-operated because of prosthetic valve obstruction and suspicion of recurrence that was not confirmed. Because of the illustrative images and different presentations, we found it interesting to report and discuss them together.
Keywords: Mitral valve; Myxoma; Echocardiography; Transoesophageal echocardiography