Transesophageal Two-Dimensional Echocardiography for Detection of Left Atrial Masses

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Abstract
Two-dimensional echocardiography is a useful tool for diagnosis of intracardiac masses. However, there are limitations to this technique, particularly when dealing with the left atrial appendage using a transthoracic approach. In this study, we compared the use of two techniques, transthoracic and transesophageal echocardiography, for detection of left atrial masses, in a series of 68 patients who were suspected of having mitral valvular lesion prior to heart surgery. Eleven of the 68 cases were found to have intracardiac masses. Six of the 11 had left atrial thrombi, 4 had left atrial myxoma, and 1 case had malignant sarcoma. We found a discrepancy between the two techniques. Using transthoracic echocardiography, we found 5 false-negative results (4 left atrial thrombi, 1 malignant sarcoma) and 1 false-positive (left atrial wall fold mimicking a thrombus). All the intracardiac masses were detected by transesophageal echocardiography. We concluded that transesophageal echocardiography is a particularly useful and more efficient approach for detection of left atrial masses than transthoracic echocardiography.

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