J Cardiovasc Ultrasound.  2009 Dec;17(4):145-147. 10.4250/jcu.2009.17.4.145.

Intracoronary Catheter Aspiration Can Be an Adequate Option in Patients with Acute Myocardial Infarction Caused by Left Atrial Myxoma

• Park HS
• Park JH
• Jeong JO

• KMID: 1473719
• DOI: http://doi.org/10.4250/jcu.2009.17.4.145

Abstract

Cardiac myxomas are the most common benign cardiac tumors and can be associated with systemic embolization including acute myocardial infarction (AMI). The probability of an arterial embolization is closely related to a tumor's villous morphology. In cases of AMI caused by cardiac myxoma, open heart surgery including excision of the coronary artery has been the one of the treatment options for removing the myxoma and embolus from the coronary artery to maintain distal coronary flow. However, preparing for emergent open heart surgery takes a considerable amount of time. Moreover, this time delay can deteriorate the coronary perfusion to the infarcted area and is associated with poor clinical prognosis. So intracoronary catheter aspiration can be an additional option to maintain the distal coronary flow. In this report we present a case with acute anterior ST elevation myocardial infarction caused by a left atrial myxoma. The embolus in the left anterior descending coronary artery was successfully removed with intracoronary catheter aspiration, and distal coronary flow was restored after the procedure.

Keyword

Myxoma; Acute ST elevation myocardial infarction; Intracoronary aspiration

MeSH Terms

Catheters
Coronary Vessels
Embolism
Heart Neoplasms
Humans
Myocardial Infarction
Myxoma
Perfusion
Prognosis
Thoracic Surgery

Figure

• 

  Fig. 1 The echocardiogram performed at admission shows a villous left atrial myxoma that prolapses to the left ventricle in the diastolic phase. There is also akinesis of the mid to apical anterior walls, suggesting ischemia of the left anterior descending coronary artery. A: End-systolic phase. B: Middiastolic phase.

• 

  Fig. 2 Primary percutaneous coronary intervention was performed at admission. The distal left anterior coronary artery shows total occlusion (white arrow). After successful intracoronary aspiration by suction catheter, the lesion was fully reperfused. A: Initial coronary angiogram. B: Coronary angiogram after intracoronary aspiration.

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