spontaneous cure of infected left atrial myxoma following embolization

Abstract

A patient with prolonged duration, bacterial infection, and echocardiographic disappearance of an atrial myxoma following embolization is discussed. Following aortic saddle embolus, all echocardiographic manifestations of the patient's left atrial myxoma disappeared. Previous cases of infected atrial myxomas are reviewed. The necessity of early surgical intervention, despite active infection, is discussed.

Case Details

Disease Location

Anterior leaflet of mitral valve

Personal Characteristics

51-year-old female

Clinical Characteristics

Admitted with severe headache, disorientation well until 15 years prior to admission when she sustained cerebrovascular accident presumed to be embolic treated with coumadin until present admission CT scan revealed left cerebellar hemorrhage & left parietal infarction chest x-ray normal echocardiogram after surgery showed multiple echoes behind anterior leaflet of mitral valve in diastole--> diagnosed as left atrial myxoma few months later, experienced sudden pain & numbness in legs--> diagnosed as aortic saddle embolus

Remission Characteristics

Repeat echocardiogram performed after laparoscopy entirely within limits no echoes behind anterior leaflet of mitral valve no evidence of mass in left atrium, repeat blood cultures (-) patient remained asymptomatic on no therapy & discharged most recent evaluation 8 mths later normal

Treatment & Mechanisms

Proposed Remission Mechanisms

In time b/w craniotomy & laparoscopy patient suffered from bacterial endocarditis treated with intravenous penicillin therapy bacteremia may have influenced regression

Clinical Treatment

Suboccipital craniotomy & drainage of posterior fossa hematoma performed laparoscopy performed to remove embolus