日比 範夫, 高階 康子, 飯田 邦彦, 加藤 享嗣, 橋本 龍生, 柿沼 善弘, 神戸 忠

Norio HIBI, Yasuko TAKASHINA, Kunihiko IIDA, Kyoji KATOH, Tatsuo HASHIMOTO, Yoshihiro KAKINUMA, Tadashi KAMBE

名古屋大学医学部第三内科

The Third Department of Internal Medicine, School of Medicine, Nagoya University

キーワード : Two-dimensional echocardiography, Atrial myxoma, Cardiac operation, Mass of echoes

　Eighteen patients with left atrial myxoma were studied with two-dimensional echocardiography (2D Echo) in order to estimate the characteristics of the tumor and to compare the findings before and after cardiac surgery. Six patients were male and 12 were female. The age ranged from 6 to 71 years with an average of 42.8 years. Echocardiographic examination was performed with a Sonolayergraph SSL-51H with mechanical sector scanner or SSH-11A and SSH-60A with electronic phased-array sector scanner of Toshiba.
　The left atrial myxoma was demonstrated as a mass of echoes in the left atrial chamber during systole and it moved to the left ventricle in diastole. The size, shape and movement of the tumor were well estimated with 2D Echo. In addition, the stalk length and its attached site were also analyzed by 2D Echo. The stalk was attached to the interatrial septum in 16 cases, and to the posterior wall of the left atrium in the remaining two. Seven patients had a spherical (ball-like) tumor and the cluster of tumor was recorded in another eleven.
　The myxomas were successfully removed from the left atrial chamber by surgical intervention in 17 cases. The weight of the tumor ranged from 3.3 g to 92 g.
Postoperatively, the E amplitude of the mitral valve was normalized in all cases, and the E-F slope was also improved to normal range except one. The left atrial dimension became smaller than preoperatively.
　No recurrence of the myxoma was found in all cases for ll years.
　Two-dimensional echocardiography is thought to be a useful method to diagnose left atrial myxoma and to estimate the hemodynamic status of tumor.