scholarly journals Cardiac Myxomas: A single center experience and ten-years follow up

2019 ◽  
Vol 1 (2) ◽  
pp. 40-48
Author(s):  
Essam Elbadry Hashim Mohamed ◽  
Ayman Mohamed Mohamed Abdel Ghaffar ◽  
Khaled Mohamed Abdelaal ◽  
Abdelrahman Adel Abdelaziz Elsayed ◽  
Mohamed AW Ezzat ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Approach ◽  
Postoperative Bleeding ◽  
Cardiac Myxoma ◽  
Surgical Excision ◽  
Right Atrial ◽  
Tricuspid Valve Repair ◽  
Supraventricular Arrhythmia ◽  
Pulmonary Atelectasis ◽  
Cardiac Myxomas

Background: Cardiac myxoma is a benign tumor that carries the risk of embolization and obstruction of the blood flow. The ideal surgical approach is still debatable. We present our experience in the surgical treatment of cardiac myxomas and its ideal surgical approach.Methods: We retrospectively analyzed the data for all patients who underwent surgical excision of cardiac myxoma at our institution over 11 years starting from January 2006 to December 2016. Descriptive statistics were used to present preoperative, operative and postoperative data and Kaplan Meier curve to plot long-term survival.Results: Twenty-one patients had surgical excision of a primary, single and sporadic cardiac myxoma. Thirteen patients (62 %) were females, and the mean age at operation was 55.2 years (range: 28 – 71 years). The location of myxomas was in the left atrium in 17 patients (81%) and right atrium in 4 patients (19 %). Dyspnea was the main presenting symptom (71.4%) followed by constitutional symptoms (28%), palpitations (23.8%), syncope (14.2%) and stroke (14.2%). A right atrial trans-septal incision was used in 76.5% of left atrial myxoma cases. Five patients had concomitant operative procedures (coronary artery bypass grafting (n=2), tricuspid valve repair (n=1), mitral valve replacement (n=1) and bullectomy (n=1)). Postoperative complications were reported in six patients (28.6%) (supraventricular arrhythmia (n=2), temporary conduction deficit (n=2), pulmonary atelectasis (n=1), and postoperative bleeding (n=1)). Early postoperative mortality occurred in one patient (4.76 %), and there were no late deaths related to myxoma.Conclusion: Surgical treatment of cardiac myxoma is safe with low morbidity and mortality. The right atrial trans-septal incision is the recommended surgical approach.

scholarly journals Cardiac myxoma: The influence of preoperative clinical presentation and surgical technique on late outcome

2007 ◽  
Vol 135 (7-8) ◽  
pp. 401-406
Author(s):  
Aleksandar Mikic ◽  
Biljana Obrenovic-Kircanski ◽  
Mladen Kocica ◽  
Mile Vranes ◽  
Vesna Lackovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Presentation ◽  
Cardiac Myxoma ◽  
Surgical Techniques ◽  
Right Atrial ◽  
Functional Improvement ◽  
Primary Tumors ◽  
Cardiac Myxomas ◽  
The Right

Introduction Cardiac myxomas are the most frequent primary tumors of the heart in adults, and they can be found in each of four cardiac chambers. Although biologically benign, due to their unfavorable localization, myxomas are considered "functionally malignant" tumors. Diagnosis of cardiac myxoma necessitates surgical treatment. Objective To analyze: 1) the influence of localization, size and consistency of cardiac myxomas on preoperative symptomatology; 2) the influence of different surgical techniques (left, right, biatrial approach, tumor basis solving) on early, and late outcomes. Method From 1982 to 2000, at the Institute for Cardiovascular Diseases, Clinical Center of Serbia, there were 46 patients with cardiac myxomas operated on, 67.4% of them women, mean age 47.1?16.3 years. The diagnosis was made according to clinical presentation, electrocardiographic and echocardiographic examinations and cardiac catheterization. Follow-up period was 4-18 (mean 7.8) years. Results In 41 (89.1%) patients, myxoma was localized in the left, while in 5 (10.9%), it was found in the right atrium. Average size was 5.8?3.8 cm (range: 1?1 cm to 9?8 cm) and 6?4 cm (range: 3?2 cm to 9?5 cm) for the left and right atrial myxomas, respectively. A racemous form predominated in the left (82.6%) and globous in the right (80%) atrium. Fatigue was the most common general (84.8%) and dyspnoea the most common cardiologic symptom (73.9%). Preoperative embolic events were present in 8 patients (4 pulmonary, 4 systemic). In our series: 1) different localization, size and consistency had no influence on the preoperative symptomatology; 2) surgical treatment applied, regardless of different approaches and basis solving, resulted in excellent functional improvements (63.1% patients in NYHA III and IV class preoperatively vs. 6.7% patients postoperatively) and had no influence on new postoperative rhythm disturbances (8.7% patients preoperatively vs. 24.4% patients postoperatively); 3) early (97.8%), and late survival rates (91.3%) were excellent; 4) there were no relapses during the follow-up period. Conclusion Localization, size and consistency had no influence on the preoperative symptomatology. Excellent survival rate with significant functional improvement, rare postoperative complications and no recurrences, justify the applied strategies of surgical approach and tumor basis solving in our series.

Atypical Left Ventricular Myxoma: Unusual Echocardiographic and Histopathological Features

2018 ◽  
Vol 11 (4) ◽  
pp. NP129-NP131
Author(s):  
Sushil Azad ◽  
Nilanjan Dutta ◽  
Kuntal Roy Chowdhuri ◽  
Tarun Raina Ramman ◽  
Nishit Chandra ◽  
...  
Keyword(s):  
Hydatid Cyst ◽  
Histopathological Examination ◽  
Cardiac Myxoma ◽  
Surgical Excision ◽  
Interatrial Septum ◽  
Left Ventricular ◽  
Cardiac Tumors ◽  
Complete Surgical Excision ◽  
Vascular Proliferation ◽  
Cardiac Myxomas

Cardiac myxomas are the most common primary cardiac tumors and are typically attached to the interatrial septum. Left ventricular myxomas are exceedingly rare and presentation in children is all the more uncommon. We report a case of left ventricular myxoma with very atypical cystic appearance raising an initial suspicion of a hydatid cyst. Subsequently, cardiac magnetic resonance imaging was done, which ruled out the diagnosis of hydatid cyst. Complete surgical excision was done through transaortic and transmitral route. Histopathological examination revealed it to be a cardiac myxoma with vascular proliferation, which on echocardiography had appeared as a polycystic lesion. This is a very unusual histopathological presentation of cardiac myxoma.

scholarly journals Complicated Sporadic Cardiac Myxomas: A Second Recurrence and Myxomatous Cerebral Aneurysms in One Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Mazen E. Iskandar ◽  
Kamellia Dimitrova ◽  
Charles M. Geller ◽  
Darryl M. Hoffman ◽  
Robert F. Tranbaugh
Keyword(s):  
De Novo ◽  
Cardiac Myxoma ◽  
Cerebral Aneurysms ◽  
Atrial Myxoma ◽  
Right Atrial ◽  
Cerebral Angiogram ◽  
Left Atrial Myxoma ◽  
Right Atrial Myxoma ◽  
Cardiac Myxomas ◽  
Matrix Patches

A second recurrence of an excised nonfamilial cardiac myxoma is rare. Myxomatous cerebral aneurysms as a complication of cardiac myxomas are equally rare. A unique case of a patient with a total of 4 myxomas over a 20-year interval is presented. Her most recent presentation was a second recurrence of a left atrial myxoma, a de novo right atrial myxoma, and multiple cerebral myxomatous aneurysms. The challenging reconstruction of the normal anatomy was achieved with the use of porcine extracellular matrix patches. A diagnostic cerebral angiogram was later performed, and the aneurysms will be monitored for growth and possible intervention.

Management of Cardiac Myxomas

1997 ◽  
Vol 5 (3) ◽  
pp. 158-161
Author(s):  
Lim Yeong Phang ◽  
Tan Yong Seng
Keyword(s):  
Coronary Artery ◽  
Left Atrial ◽  
Artery Bypass ◽  
Cardiac Myxoma ◽  
Atrial Myxoma ◽  
Right Atrial ◽  
Primary Tumors ◽  
Left Atrial Myxoma ◽  
Singapore General Hospital ◽  
Cardiac Myxomas

Cardiac myxomas are benign primary tumors of the heart that require prompt surgical intervention because of the possibility of developing syncope and hemodynamic or embolic complications. From 1 January 1981 to 31 December 1996, 20 patients (11 male and 9 female) underwent surgery for cardiac myxoma at Singapore General Hospital. Nineteen patients had a left atrial myxoma and 1 had a right atrial myxoma. Five patients had concomitant coronary artery disease including one with severe mitral regurgitation. Nine patients presented with progressive dyspnea, 5 with systemic embolus, 2 with syncope, 3 with congestive cardiac failure, and 1 with right ventricular failure. In 6 patients the diagnosis was established by cardiac catheterization and 14 patients were diagnosed by two-dimensional echocardiography. Cardiopulmonary bypass with mild to moderate systemic hypothermia was used for excision of the myxoma in all cases. Five patients had concomitant coronary artery bypass grafting and 2 had concomitant mitral valve replacement. There was no hospital mortality among patients who had only excision of the myxoma, including a patient who had a recurrence of her left atrial myxoma 5 years after the initial excision. There were 2 deaths in patients with coexisting cardiac and other diseases. Surgical excision is recommended for all cases of cardiac myxoma. There is little risk associated with this procedure. All patients should be followed up regularly with echocardiographic assessment as there is a small risk of recurrence.

scholarly journals Cardiac masses due to tumors (diagnosis, clinical manifestations and surgical treatment)

2014 ◽  
Vol 95 (6) ◽  
pp. 806-810 ◽  
Author(s):  
D L Kranin
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
Surgical Excision ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Low Grade ◽  
Imaging Results ◽  
Valvular Heart Diseases ◽  
Cardiac Myxomas

Aim. To summarize the experience on the diagnosis and surgical treatment of primary benign and malignant cardiac tumors. Methods. The paper describes 37 clinical observations of endocavitary primary benign and malignant cardiac tumors: 26 (70.3%) cases of cardiac myxoma, 5 (13.5%) - rhabdomyosarcoma, 2 (5.4%) - angiosarcoma, 1 (2.7% ) - leiomyosarcoma, 1 (2.7%) - fibrosarcoma, 1 (2.7%) - liposarcoma. Patients were 15 (40.5%) males and 22 (59.5%) females aged 18 to 65 years. Endocavitary cardiac tumors were diagnosed by noninvasive tests: echocardiography, computed tomography, magnetic resonance imaging. Results. Patients with primary benign and malignant cardiac tumors had variable clinical manifestations. Symptoms of astenoneurotic syndrome, auscultatory and cardiophonographic signs simulating acquired or congenital valvular heart diseases, which often have a positional relationship; low-grade fever of unknown origin, weight loss were registered. Paraneoplastic syndrome was characterized by an increase in erythrocyte sedimentation rate, leukocytosis, monocytosis, dysproteinemia, polycythemia, hypochromic anemia, increased levels of C-reactive protein. Surgical excision of 25 cardiac myxomas and 8 malignant tumors of the heart was performed with cardiopulmonary bypass, pharmacological cardioplegia and general hypothermia. In 1 case the tumor resection was combined with coronary artery bypass grafting. In 3 patients suffering from malignant tumors, explorative thoracotomy was performed. Surgical revision, emergency and planned microscopic studies of removed cardiac tumors allowed to establish the final clinical diagnosis. Hospital mortality among patients operated for cardiac myxomas was 4.0%, for cardiac malignant tumors - 27.3%. Conclusion. Timely surgical treatment of patients with primary cardiac benign tumors (myxomas) leads to recovery and is accompanied by a relatively low mortality; better results of patients with cardiac endocavitary tumors treatment depend on the early detection and timely radical surgical excision.

scholarly journals Diagnosis of Carney complex following multiple recurrent cardiac myxomas

2021 ◽  
Author(s):  
Shigeki Yokoyama ◽  
Kanetsugu Nagao ◽  
Akihiko Higashida ◽  
Masaya Aoki ◽  
Shigeyuki Yamashita ◽  
...  
Keyword(s):  
Surgical Excision ◽  
Genetic Mutation ◽  
Carney Complex ◽  
Right Atrial ◽  
Systemic Review ◽  
Cardiac Tumors ◽  
Left Atrial Myxoma ◽  
Atrial Tumors ◽  
Cardiac Myxomas ◽  
The Right

AbstractCarney complex is a rare syndrome caused by a genetic mutation leading to multiple endocrine abnormalities and a variety of tumors. Here, we report a case of Carney complex diagnosed due to recurrent multiple myxomas in the right atrium of a patient 16 years after the resection of the primary left atrial myxoma. Surgical excision was performed for the multiple recurrent right atrial tumors under cardiopulmonary bypass. The patient remained complication-free after surgery and was discharged on the 14th day. He was scheduled to continue echocardiographic follow-up and periodic systemic review by an endocrinologist. This case emphasizes the fact that if cardiac myxomas tend to be multiple and recurrent at a relatively young age, the possibility of Carney complex should be considered, even in the absence of any other related feature other than cardiac tumors.

Surgical Treatment of an Aorto-Right Atrial Fistula as a Complication of Tricuspid Valve Repair

2011 ◽  
Vol 59 (04) ◽  
pp. 250-252 ◽  
Author(s):  
P. Menon ◽  
T. Doenst ◽  
J. Ender ◽  
F. Mohr ◽  
D. Mathioudakis
Keyword(s):  
Surgical Treatment ◽  
Tricuspid Valve ◽  
Right Atrial ◽  
Tricuspid Valve Repair ◽  
Valve Repair

scholarly journals Rare Case of 6 cm Right Atrial Myxoma in Patient with Synchronous Endometrial Adenocarcinoma

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Mohammad Altujjar ◽  
Feras Zaeim ◽  
Erin Sheehan ◽  
Wily Gan ◽  
Mohammed Mhanna ◽  
...  
Keyword(s):  
Rare Case ◽  
Endometrial Adenocarcinoma ◽  
Cardiac Myxoma ◽  
Atrial Myxoma ◽  
Right Atrial ◽  
Cardiac Tumors ◽  
Right Atrial Mass ◽  
Right Atrial Myxoma ◽  
Cardiac Myxomas ◽  
Primary Cardiac Tumors

Primary cardiac tumors are extremely rare. Cardiac myxomas most frequently appear in the left atrium. In this article, we present a case of an asymptomatic 6 cm right atrial mass in a patient undergoing staging for endometrial cancer. The mass was resected, and final pathology was consistent with cardiac myxoma.

scholarly journals Outcomes of Patients with Cardiac Myxoma: A Retrospective Multicentre Study

2019 ◽  
Vol 13 (1) ◽  
pp. 24-30
Author(s):  
Umit Duman ◽  
Cevdet Furat ◽  
Gokhan Keskin ◽  
Dogan Kahraman ◽  
Erhan Hafiz
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Nephrotic Syndrome ◽  
Cardiac Myxoma ◽  
Right Heart Failure ◽  
Surgical Excision ◽  
Right Atrial ◽  
Tumour Resection ◽  
Cardiac Symptoms ◽  
Asymptomatic Patients

Background:We present a 15-year follow-up of patients with Cardiac Myxoma (CM) who underwent tumour resection.Patients and Methods:Between 2001 and 2016, 38 patients with CM were operated on. We retrospectively reviewed, their clinical presentations. We also analysed the echocardiographic, electrocardiographic and pathology reports.Results:No mortality was seen after surgery. The mean age of the patients was 41.7±7.8 years and the female/male ratio was 22/16. Two patients with CM were children. The main symptoms of left atrial CM were dyspnoea on exertion, chest pain and congestive heart failure. Tricuspid valve pathology, and leg oedema were the main symptoms in patients with right atrial CM combined with right heart failure. CM as a cause of nephrotic syndrome was detected in 2 patients. In 5 asymptomatic patients (13.1%), CM was detected incidentally. We detected a pericardial invasion by the tumour in 1 patient. We performed secondary surgery because of tumour recurrence in 2 patients. Overall, survival for patients after surgical excision was 96.4±1.6% at 1 year, 91.7±2.4% at 5 years, 87.6±2.6% at 10 years and 85±1.9% at 15 years.Conclusion:The symptoms of CM may include congestive heart failure or nephrotic syndrome. Because CM may be associated with serious cardiac symptoms, tumour excision should be performed immediately after diagnosis. The use of right anterior thoracotomy for CM resection is a safe surgical approach.

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