Large left atrial myxoma with functional mitral stenosis: a case report.

BACKGROUND: Left atrial myxomas are rare, potentially life-threatening benign cardiac tumors. Early surgical excision is recommended to prevent embolic events, obstruction, and sudden death. A 72-year-old Turkish woman presented with exertional dyspnea and palpitations. Transthoracic echocardiography demonstrated a 4.7 cm × 2.7 cm mobile left atrial mass attached to the interatrial septum and prolapsing into the mitral orifice with a mean transmitral gradient of 9 mmHg and no evidence of embolization. Elective median sternotomy under cardiopulmonary bypass via a right atriotomy-transseptal approach enabled en bloc excision with primary septal closure. Postoperative transesophageal echocardiography confirmed complete resection with preserved mitral valve function, and the mean transmitral gradient fell immediately to ~1.3-1.4 mmHg, indicating prompt hemodynamic normalization. Recovery was uneventful, and the patient was discharged on postoperative day 8.

DISCUSSION: This case demonstrates the rapid reversal of myxoma-related functional mitral stenosis following valve-sparing transseptal excision, with immediate normalization of the mean transmitral gradient.