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Case Reports

Emergency Surgery for Acute Mitral Valve Obstruction Resulting From Hemorrhage Within a Left Atrial Myxoma

^a Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands
^b Department of Pathology, St. Antonius Hospital, Nieuwegein, the Netherlands

Accepted for publication June 2, 2008.

^_* Address correspondence to Dr Sonker, Department of Cardiothoracic Surgery, St. Antonius Hospital, Koekoekslaan 1, Nieuwegein, 3435 CM, the Netherlands (Email: usonker{at}hotmail.com).

Left atrial myxomas are benign, slow-growing primary cardiac tumors. They present with gradual onset of one or more of a triad of obstructive, embolic, or constitutional symptoms. Transesophageal echocardiography aids in the detailed preoperative and intraoperative evaluation of the myxoma for surgical strategy planning. We describe a previously unreported case of interstitial hemorrhage in a left atrial myxoma leading to rapid expansion of the tumor with features of acute, mitral valve obstruction. Transesophageal echocardiography showed a cystic area in the left atrial tumor that corresponded to an area of recent hemorrhage confirmed on surgical removal.