Left atrial myxoma embolus to the renal artery: should a nephrectomy be advised?

Cardiac myxoma represents the most common primary cardiac tumor, which accounts for 75% of all benign cardiac tumors. Embolization is a well-known hazard of myxoma and can be a presenting feature. Resection is generally recommended for cardiac myxomata; once identified but less understood is what to do with systemic emboli. Although extremely uncommon, the literature contains a number of examples of metastatic myxomata with active growth at the site of embolic implantation, with most cases being cerebral. We present an unusual case of embolic occlusion of the right renal artery from a left ventricular myxoma. Excision of the tumor required cardiac autotransplantation and mitral valve replacement. Subsequent right nephrectomy revealed renal artery occlusion with pathologically viable myxoma tissue. Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.