冠状動脈左房瘻を呈した豊富な栄養血管を有する左房粘液腫の1例

Left Atrial Myxoma with Coronary Artery-left Atrial Fistula：Report of a Case

はじめに　心臓粘液腫は原発性心臓腫瘍の中でもっとも頻度が高い1）．冠状動脈造影検査により，粘液腫の栄養血管が同定されることがある2）．われわれは，心エコー検査および冠状動脈造影検査で冠状動脈左房瘻を呈した左房粘液腫の1例を経験したため，文献的考察を加えて報告する．

A 76-year-old woman underwent screening echocardiography. A cardiac mass was detected in the left atrium. It was located at the atrial septum, and was around 3 cm in size. Its surface was smooth and there was cystic cavity inside. Coronary angiography revealed rich blood flow from bilateral coronary arteries to the mass and massive shunt to the left atrium, which formed a fistulous connection. We performed tumor resection under cardiopulmonary bypass. Postoperative course was uneventful. Histopathologically, the tumor was myxoma. Cardiac myxoma is the most common primary cardiac tumor, but myxoma exhibiting coronary artery-left atrial fistula is fairly uncommon.