Giant Blood Cyst of the Mitral Valve
Echocardiographic and Intraoperative Images
A 25-year-old, apparently healthy woman was referred to us with suspicion of left atrial myxoma found incidentally by echocardiography. Physical examination was unremarkable except for a diastolic plop sound on cardiac auscultation. Transthoracic echocardiography showed a large, very mobile cystic mass (23×25 mm) attached to the mitral valve and mild mitral regurgitation with normal ventricular size and function (Figure 1 and Movie). At operation, a bluish cystic mass was seen attached to the anterior mitral valve leaflet with a broad base (Figure 2). Resection of mitral cyst and mitral valve repair was performed successfully. Histological examination showed a blood-filled cystic cavity surrounded by a fibromyxoid wall with an internal lining of endothelial cells. The postoperative course was uneventful. Although small blood-filled cysts of the heart valves are sometimes found at postmortem examination of infants, a large cyst found in an adult is very rare.
The online-only Data Supplement, which contains a movie, can be found at http://circ.ahajournals.org/cgi/content/full/112/22/e341/DC1.