Diagnosis of abnormal intra-atrial echoes. Contribution of transesophageal echocardiography]

The aim of this study was to evaluate the results of transesophageal echocardiography in the diagnosis of abnormal intraatrial echoes detected by transthoracic echocardiography. Patients with active endocarditis, mitral stenosis, and valve prostheses were excluded. The 47 patients (28 women and 19 men) were classified into 4 groups according to the results of transesophageal echocardiography. Group I: normal (7 cases), "phantom echos"; Group II: anatomical variants (9 cases), Chiari apparatus, muscular spur; Group III: pseudo-tumours (7 cases); retro-atrial haematoma, mitral valve prolapse, interatrial septal aneurysm; Group IV: cardiac masses (24 cases). This group comprises: typical myxomas (10 cases), typical thrombi (2 cases), localised atypical masses, relatively immobile and non-prolapsing: 5 myxomas, 1 metastasis, 2 thrombi. The results of this study suggest that transesophageal echocardiography is very useful in diagnosing suspected abnormal intraatrial echos observed on conventional transthoracic examination. However, the nature of the mass may remain obscure.