心房中隔欠損を合併した左房粘液腫を右肋間小切開手術で治療した1例

Minimally Invasive Cardiac Surgery for a Left Atrial Myxoma with Atrial Septal Defect：Report of a Case

はじめに　粘液腫は左房内に好発するもっとも頻度の高い原発性心臓腫瘍である．しかし先天性心疾患との関連はなく，両者が合併した際の診断や治療に言及した報告は少ない．

A 48-year-old woman presented with abnormal electrocardiogram was diagnosed as having a left atrial tumor by echocardiography. She was asymptomatic and had no history of cardiac abnormality. Transthoracic echocardiography revealed a relatively hyperechoic and heterogenous tumor with the diameter of 5～6 cm originated from the left atrial septum but could not detect atrial septal defect. Transesophageal echocardiography showed atrial septal defect of fossa ovalis but failed to uncover shunt flow behind the tumor. We diagnosed as left atrial myxoma complicated with atrial septal defect, and an operation was performed through small right intercostal thoracotomy. The tumor was excised and the atrial septal defect was completely repaired after pulmonary vein isolation. The post-operative course was uneventful. Cardiac myxoma coexisting atrial septal defect is rare, and preoperative transesophageal echocardiography is considered essential for the diagnosis of coexistent lesions especially in the patients minimally invasive cardiac surgery is planned.