An unusual presentation of a usual cardiac mass: neo-vascularised left-atrial myxoma.

A 57-year-old female patient was admitted with dys-pnoea. With two-dimensional (2D) transthoracic and trans-oesophageal echocardiography, a left-atrial myxoma of 3.1 Â 4 cm was diagnosed. Coronary angiography demonstrated that the myxoma had been neo-vascularised originating from the circumflex artery (Fig. 1). The tumour was resected successfully with cardiopulmonary bypass (Fig. 2). Fig. 1. In the coronary angiography the left anterior descending artery and the circumflex artery are seen. The shadow of the myxoma is marked with the arrows. Neo-vascularisation of the left atrial myxoma originating from the first obtuse marginal branch of circumflex artery is obvious. Fig. 2. The operation was performed under general anaesthesia with cardio-pulmonary bypass. Via right atriotomy and transseptal approach the cyst was excised from the left atrial roof. The left atrial roof was then repaired with pericardial patch.