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Circulation, Vol 83, 70-78, Copyright © 1991 by American Heart Association
A Mugge, WG Daniel, A Haverich and PR Lichtlen
This study was conducted in 46 patients with cardiac thrombi, 15 patients
with atrial myxomas, and 32 patients with other cardiac or paracardiac
tumors. Diagnoses were subsequently proven by surgery, autopsy, computed
tomography, magnetic resonance imaging, or angiography in all patients. All
patients underwent precordial and transesophageal two-dimensional
echocardiography to assess the various mass detection rates. Atrial myxomas
and predominantly left-sided cardiac tumors were identified by both
echocardiographic techniques with comparable detection rates. Left
ventricular apical thrombi were detected more frequently by precordial
echocardiography. In contrast, transesophageal echocardiography was
superior in visualizing left atrial appendage thrombi, small and flat
thrombi in the left atrial cavity, thrombi and tumors in the superior vena
cava, and masses attached to the right heart and the descending thoracic
aorta. These data indicate that transesophageal echocardiography leads to a
clinically relevant improvement of the diagnostic potential in patients in
whom cardiac masses are suspected or have to be excluded in order to ensure
the safety of clinical procedures.
ARTICLES
Diagnosis of noninfective cardiac mass lesions by two-dimensional echocardiography. Comparison of the transthoracic and transesophageal approaches
Division of Cardiology, Hannover Medical School, FRG.
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