Atrial myxoma: report of 24 operations using the biatrial approach.

Between October 1978 and June 1993, 24 consecutive operations for atrial myxoma were performed on 23 patients at the Damascus University Cardiovascular Surgical Center, using the biatrial approach. Fifteen of the patients were female; ages ranged between 4 and 71 years. Nineteen patients had symptoms of left and 3 of right atrioventricular obstruction. One patient presented with a cerebrovascular accident, and another with recurrent emboli to the lower extremities. Ten patients had constitutional manifestations. Diagnosis was established preoperatively in all patients by echocardiography with or without angiocardiography. Twenty-one patients had left atrial myxoma, 1 of whom had a double lesion. Two patients had right atrial myxoma; in 1 of them it extended to the left atrium. This last patient had the only recurrence in the series, which was removed 7 years after the initial operation. All tumors were excised with a wide margin of full-thickness septum. Four patients had concomitant mitral valve reconstruction. There was no hospital mortality, and follow-up did not reveal any other complication related to the operation.

Combined supravalvular aortic stenosis and hypertrophic subaortic stenosis: coexistence or association?

A 19-year-old male was found to have combined supravalvular aortic stenosis and hypertrophic subaortic stenosis. Two possible hypotheses with supportive evidence in the literature may explain this association: (1) long-standing fixed supravalvular aortic stenosis may result in secondary hypertrophic subaortic stenosis, and (2) infantile hypercalcemia, a condition closely related to supravalvular aortic stenosis, may also be involved by continuous inotropic stimulation in the pathogenesis of muscular hypertrophy and subaortic stenosis of the left ventricle. We tend to favor the second theory in light of recent evidence in the literature.