Two-dimensional echocardiographic diagnosis of left atrial myxoma.

Two patients with left atrial myxomas detected with one-dimensional echocardiographic studies were evaluated before and after surgery with real-time phased-array two-dimensional echocardiographic studies. This latter technique provided relatively quantitative information regarding the size, shape, and mobility of the tumor and its effect on cardiac function. In case 1, the two-dimensional echocardiogram showed a relatively immobile tumor measuring 3 × 4.5 cm in diameter in the left atrium only. At surgery a 2 × 4.5-cm myxoma that was attached to the left atrium by a broad-based short stalk was removed. In case 2, the left atrial mass appeared to be 3 × 4 cm in diameter, with much movement during the cardiac cycle. At surgery a 3 × 4-cm left atrial myxoma that was attached to the interatrial septum by a long stalk was removed. In both cases, masses in other cardiac chambers were excluded, the mitral valves were normal, and left ventricular function was normal, all of which were confirmed at surgery and by postoperative echocardiograms. In one patient the information obtained by two-dimensional echocardiographic studies was believed to be sufficient to preempt the need for cardiac catheterization. These cases illustrate that this new noninvasive technique may provide sufficient quantitative preoperative detail in patients with left atrial tumors to obviate the risk and expense of cardiac catheterization.