Cardiovascular Magnetic Resonance Imaging has evolved during the last 2 decades as the reference standard imaging modality to assess the anatomic and functional sequelae in patients with repaired ToF. Tetralogy of Fallot is the most common type of cyanotic congenital heart disease. It consists of a right ventricle (RV) outflow tract obstruction, a malalignment ventricular septal defect, an overriding aorta, and right ventricular hypertrophy. In addition, ToF is associated with other congenital cardiac abnormalities in about 40% of patients. Some of the more common anomalies...

A 28 year-old male patient with a prior history of repaired tetralogy of Fallot was admitted to the Cardiology Department with progressive shortness of breath. Transthoracic echocardiography demonstrated severe pulmonary regurgitation with akinesia of right ventricular outflow (RV) tract and RV dilatation. A mobile mass was prominent in the right ventricular apex and intracardiac thrombosis was suspected.Cardiac Magnetic Resonance (CMR) was requested for further investigation. The images were obtained using a Siemens Avanto 1,5T MR system. Morphological, Cine (SSFP), angiographic and delayed gadolinium enhanced (PSIR)...

The exam revealed severe Right Ventricle dilatation(EDV 278,7 ml/m2) with regional and global dysfunction (EF 34,6%), flattening of the interventricular septum,pulmonary regurgitation, RVOT aneurysm, severe pulmonary artery dilatation, tricuspid and aortic regurgitation,inferior vena cava dilatationand an heterogeneous enhanced mass located in the apical part of RV. The findings where suggestive for an atypically located myxoma.Patient underwent pulmonary valve replacement and removal of the mass (which histologically proved that it was a myxoma) under cardiopulmonary bypass.

Cardiac myxoma is rarely located in the right ventricle. Carney’s complex, and family history should be sought out when encountering a myxoma in a young adult especially in an uncommon location. The diagnostic value of CMR is crucial.To our knowledge this is the first described case with this unusual combination

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Alexandros Kallifatidis, Radiologist MD Department of Radiology, St. Luke's Hospital, 552 36 Panorama-Thessaloniki, Greece Tel: 0030 2310-380000 Tel: 0030 2310-380035 [email protected]