A Case of a Left Atrial Mass in an Orthotopic Heart Transplant Recipient

Figures

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  Figure 1. Two-dimensional echocardiographic images including (A) four-chamber view, (B) zoomed four-chamber view of left atrium, (C) three-chamber view, and (D) subcostal four-chamber view of large left atrial mass adherent to the interatrial septum (white arrow). The mass appears to have smooth borders and an irregular shape and appears echogenically heterogenous in composition. AA, Ascending aorta; DA, descending aorta; IAS, intra-atrial septum; LA, left atrium; LV, left ventricle; MV, mitral valve; RA, right atrium; RV, right ventricle.

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  Figure 2. Two-dimensional echocardiographic images of large left atrial mass (dashed white lines). (A) Zoomed four-chamber view of left atrium with large left atrial mass extending out from the interatrial septum measuring 2.79 × 3.90 cm. (B) Contrast-enhanced four-chamber view of large left atrial mass measuring 4.06 × 4.42 cm. On contrast study, the mass appears homogenously absent of contrast uptake. IAS, Intraatrial; LA, left atrium; LV, left ventricle; MV, mitral valve; RA, right atrium; RV, right ventricle.

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  Figure 3. Transesophageal echocardiographic images of a large homogenous well-circumscribed left atrial mass (white arrow). (A) Midesophageal biatrial view of left atrial mass. (B) Midesophageal biatrial X-plane view of left atrial mass appears attached to atrial septum measuring 5.25 × 3.05 cm at the largest point. (C) Three-dimensional midesophageal echocardiographic view showing large left atrial mass with thin stalk (white star) projecting from atrial septum. Ao, Aorta; IAS, intra-atrial septum; LA, left atrium; RA, right atrium.

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  Figure 4. Cardiac computed tomographic angiographic contrast-enhanced images of large homogenous left atrial mass (white arrow) that appears adherent to the atrial septum by stalk. AA, Ascending aorta; AV, aortic valve; DA, descending aorta; IAS, intra-atrial septum; LA, left atrium; LV, left ventricle; MV, mitral valve; RA, right atrium; RV, right ventricle.

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  Figure 5. Cardiac computed tomographic angiographic three-dimensional rendering showing a large homogenous left atrial mass (white arrow) that appears adherent to the atrial septum by stalk. AA, Ascending aorta; CR, Coumadin ridge; DA, descending aorta; IAS, intra-atrial septum; LA, left atrium; LAA, left atrial appendage; LV, left ventricle; MV, mitral valve; RA, right atrium.

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  Figure 6. Two-dimensional echocardiographic images (A) basal short-axis and (B) subcostal view of ill-defined left atrial mass (outlined in white dots) after 3 months on oral anticoagulation with apixaban 5 mg twice daily. Ao, Aorta; IAS, intra-atrial septum; LA, left atrium; LV, left ventricle; RA, right atrium.