Key result
Preoperative coronary angiography guides safe left atrial myxoma excision in anomalous retro-aortic circumflex anatomy.
Why the study?
Although cardiac myxoma is the most frequent benign primary heart tumour and congenital coronary anomalies occur in roughly 1% of coronary angiograms, no previous report had described the two occurring together.
Case Report (n=1)
No
Answers are grounded in this paper and cite their sources.
This first reported case of a left atrial myxoma coexisting with an anomalous retro-aortic circumflex coronary artery highlights the importance of routine preoperative coronary imaging before cardiac tumour excision to prevent intraoperative coronary injury and ensure adequate myocardial protection.
Background. Myxoma is the most frequent benign primary tumour of the heart, and most arise in the left atrium. Congenital coronary anomalies are seen in roughly 1% of coronary angiograms. We found no previous report of the two occurring together. Case presentation. A 66-year-old woman was referred for exertional dyspnoea. Transthoracic echocardiography showed a large, mobile left atrial mass prolapsing into the mitral orifice, with a mean transmitral gradient of 16.8 mmHg. Routine coronary angiography before surgery showed a circumflex artery arising from the right coronary sinus and running behind the aorta. The tumour was excised and she recovered without complications. Conclusion. As far as we know, this is the first description of a left atrial myxoma combined with an anomalous circumflex origin. In our view, coronary imaging before tumour surgery is worth doing even in patients without angina, mainly to know where the coronary arteries run before the heart is opened.
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Fihri et al. (2026) conducted a case report in Left atrial myxoma with anomalous circumflex coronary artery origin (n=1). Preoperative coronary angiography and surgical excision of left atrial myxoma under cardiopulmonary bypass was evaluated on Complete surgical excision and freedom from postoperative symptoms and complications at 3 months. Preoperative coronary angiography identified a retro-aortic circumflex artery from the right sinus, enabling safe excision of a left atrial myxoma without complications.
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