Background: Cardiac myxoma is a very rare heart tumor which
presents as life threatening mass in cardiac chamber. The tumor may present
with vague symptoms which can lead to delay in diagnosis.Methods: 22 patients underwent complete excision of
intracardiac myxoma between January 2011 and December 2020. Majority of the
patients were females (60%) with mean age of 48.9 years who presented with symptoms of dyspnea
on exertion. 3 patients had significant complications due to
myxoma. 2 presenting with tumor embolism and limb ischemia while 1 patient
presented with pulmonary edema. All patients were diagnosed by echocardiography
which helped in evaluation of size and extent of tumor. Majority of patients
underwent trans-septal biatrial approach for tumor excision.Results: 95% of patients survived the operation. The mean
tumor size excised was 5.0±1.6 cm in the largest diameter. 11 patients had sessile tumor while 1
patient had dumb bell tumor occupying both atria. 15 patients were surviving
the operation while 2 deaths happened after 6 years of surgery.Conclusion:
References
[1]
Reynen, K. (1995) Cardiac Myxomas. The New England Journal of Medicine, 333, 1610-1617. https://doi.org/10.1056/NEJM199512143332407
[2]
Patel, J. and Sheppard, M.N. (2010) Pathological Study of Primary Cardiac and Pericardial Tumours in a Specialist UK Centre: Surgical and Autopsy Series. Cardiovascular Pathology, 19, 343-352. https://doi.org/10.1016/j.carpath.2009.07.005
[3]
Maraj, S., Pressman, G.S. and Figueredo, V.M. (2009) Primary Cardiac Tumors. International Journal of Cardiology, 133, 152-156. https://doi.org/10.1016/j.ijcard.2008.11.103
[4]
Bakaeen, F.G., Reardon, M.J., Coselli, J.S., Miller, C.C., Howell, J.F., Lawrie, G.M., et al. (2003) Surgical Outcome in 85 Patients with Primary Cardiac Tumors. The American Journal of Surgery, 186, 641-647. https://doi.org/10.1016/j.amjsurg.2003.08.004
[5]
Garatti, A., Nano, G., Canziani, A., Gagliardotto, P., Mossuto, E., Frigiola, A., et al. (2012) Surgical Excision of Cardiac Myxomas: Twenty Years Experience at a Single Institution. The Annals of Thoracic Surgery, 93, 825-831. https://doi.org/10.1016/j.athoracsur.2011.11.009
[6]
Pinede, L., Duhaut, P. and Loire, R. (2001) Clinical Presentation of Left Atrial Cardiac Myxoma: A Series of 112 Consecutive Cases. Medicine, 80, 159-172. https://doi.org/10.1097/00005792-200105000-00002
[7]
Bhan, A., Mehrotra, R., Choudhary, S.K., Sharma, R., Prabhakar, D., Airan, B., et al. (1998) Surgical Experience with Intracardiac Myxomas: Long-Term Follow-Up. The Annals of Thoracic Surgery, 66, 810-813. https://doi.org/10.1016/S0003-4975(98)00591-8
[8]
Yu, K., Liu, Y., Wang, H., Hu, S. and Long, C. (2007) Epidemiological and Pathological Characteristics of Cardiac Tumors: A Clinical Study of 242 Cases. Interactive Cardiovascular and Thoracic Surgery, 6, 636-639. https://doi.org/10.1510/icvts.2007.156554
[9]
Saji, T., Yanagawa, E. and Matsuura, H. (1991) Increased Serum Interleukin-6 in Cardiac Myxoma. American Heart Journal, 122, 579-580. https://doi.org/10.1016/0002-8703(91)91022-F
[10]
Chitwood, W.R. (1992) Clarence Crafoord and the First Successful Resection of a Cardiac Myxoma. The Annals of Thoracic Surgery, 54, 997-998. https://doi.org/10.1016/0003-4975(92)90676-u
[11]
Lijoi, A., Scoti, P., Faveto, C., Canale, C., Parodi, E., Passerone, G.C., Dottori, V. and Venere, G. (1993) Surgical Management of Intracardiac Myxomas. A 16-Year Experience. Texas Heart Institute Journal, 20, 231-234.
[12]
Bjessmo, S. and Ivert, T. (1997) Cardiac Myxomas: 40 Years’ Experience in 63 Patients. The Annals of Thoracic Surgery, 63, 697-700. https://doi.org/10.1016/s0003-4975(96)01368-9
[13]
Keeling, I.M., Oberwalder, P., Anelli-Monti, M., Schuchlenz, H., Demel, U., Tilz, G.P., Rehak, P. and Rigler, B. (2002) Cardiac Myxomas: 24 Years of Experience in 49 Patients. European Journal of Cardio-Thoracic Surgery, 22, 971-977. https://doi.org/10.1016/S1010-7940(02)00592-4
[14]
Mugge, A., Daniel, W.G., Haverich, A. and Lichtlen, P.R. (1991) Diagnosis of Noninfective Cardiac Mass Lesions by Two-Dimensional Echocardiography. Comparison of the Transthoracic and Transesophageal Approaches. Circulation, 83, 70-78. https://doi.org/10.1161/01.cir.83.1.70
[15]
El Bardissi, A.W., Dearani, J.A., Daly, R.C. and Mullany, C.J. (2008) Survival after Resection of Primary Cardiac Tumors: A 48 Year Experience. Circulation, 118, S7-S15. https://doi.org/10.1161/CIRCULATIONAHA.107.783126
[16]
Karabinis, A., Samanidis, G., Khoury, M., Stavridis, G. and Perreas, K. (2018) Clinical Presentation and Treatment of Cardiac Myxoma in 153 Patients. Medicine, 97, e12397. https://doi.org/10.1097/MD.0000000000012397
[17]
He, D., Zhang, Y., Liang, Y. and Ye, S. (2015) Risk Factors for Embolism in Cardiac Myxoma: A Retrospective Analysis. Medical Science Monitor, 21, 1146-1154. https://doi.org/10.12659/MSM.893855
[18]
Siminelaxis, S., Kakourou, A., Batistatou, A., Sismandis, S., Ntoulia, A., Tsakiridis, K., et al. (2014) Thirteen Years Follow-Up of Heart Myxoma Operated Patients: What Is the Appropriate Surgical Technique? Journal of Thoracic Disease, 6, S32-S38.
[19]
Cho, J., Quach, S., Reed, J. and Osian, O. (2020) Case Report: Left Atrial Myxoma Causing Elevated C-Reactive Protein, Fatigue and Fever, with Literature Review. BMC Cardiovascular Disorders, 20, Article No. 119. https://doi.org/10.1186/s12872-020-01397-1
[20]
Butany, J., Nair, V., Naseemuddin, A., Nair, G.M. and Catton, C. (2005) Cardiac Tumours: Diagnosis and Management. The Lancet Oncology, 6, 219-228. https://doi.org/10.1016/S1470-2045(05)70093-0
[21]
Kuroczyski, W., Peivandi, A.A., Ewald, P., Pruefer, D., Heinemann, M. and Vahl, C.F. (2009) Cardiac Myxomas: Short- and Long-Term Follow-Up. Journal of Cardiology, 16, 447-454.
[22]
Actis Dato, G.M., de Benedictis, M., Actis, D.A., Ricci, A., Sommariva, L. and De Paulis, R. (1993) Long-Term Follow-Up of Cardiac Myxomas (7-31 Years). The Journal of Cardiovascular Surgery, 34, 141-143.
[23]
Yu, S.H., Lim, S.H., Hong, Y.S. and Yoo, K.J. (2006) Clinical Experiences of Cardiac Myxoma. Yonsei Medical Journal, 47, 367-371.
[24]
Jones, D.R., Warden, H.E., Murray, G.F., Hill, R.C., Graeber, G.M., et al. (1995) Biatrial Approach to Cardiac Myxomas: A 30 Year Clinical Experience. The Annals of Thoracic Surgery, 59, 851-856. https://doi.org/10.1016/0003-4975(95)00064-R
[25]
Bateman, T.M., Gray, R.J., Raymond, M.J., Chaux, A. and Czer, L.S. (1983) Arrhythmias and Conduction Disturbances Following Cardiac Operation for Removal of Left Atrial Myxomas. The Journal of Thoracic and Cardiovascular Surgery, 86, 601-607. https://doi.org/10.1016/S0022-5223(19)39129-9
[26]
Vistarini, N., Alloni, A., Aiello, M. and Vigano, M. (2010) Minimally Invasive Video-Assisted Approach for Left Atrial Atrial Myxoma Resection. Interactive CardioVascular and Thoracic Surgery, 10, 9-11. https://doi.org/10.1510/icvts.2009.217232
[27]
Lee, K.S., Kim, G.S., Jung, Y., Jeong, I.S., et al. (2017) Surgical Resection of cardiac Myxoma: A 30 Year Single Institutional Experience. Journal of Cardiothoracic Surgery, 12, Article No. 18. https://doi.org/10.1186/s13019-017-0583-7
[28]
Shah, I.K., Dearani, J.A., Daly, R.C., Suri, R.M., Park, S.J., Joyce, L.D., et al. (2015) Cardiac Myxomas: A 50 Year Experience with Resection and Analysis of Risk Factors for Recurrence. The Annals of Thoracic Surgery, 100, 495-500. https://doi.org/10.1016/j.athoracsur.2015.03.007
[29]
Samanidis, G., Khoury, M., Balanika, M. and Perrea, D.N. (2020) Current Challenges in the Diagnosis and Treatment of Cardiac Myxoma. Kardiologia Polska, 78, 269-277. https://doi.org/10.33963/KP.15254
[30]
Yuksel, A., Saba, D., Velioglu, Y., Ener, S. and Oskan, H. (2016) Biatrial Approach Provides Better Outcomes in the Surgical Treatment of Cardiac Myxomas. Brazilian Journal of Cardiovascular Surgery, 31, 309-317.
[31]
Bortolotti, U., Maraglino, G., Rubino, M., Santini, F. and Mazzucco, A. (1990) Surgical Excision of Intracardiac Myxomas: A 20 Year Follow-Up. The Annals of Thoracic Surgery, 49, 449-453. https://doi.org/10.1016/0003-4975(90)90253-3
[32]
Tasoglu, I., Tutun, U., Lafci, G., Hijaazi, A., Yener, U. and Yalcinkaya, A. (2009) Primary Cardiac Myxomas: Clinical Experience and Surgical Results in 67 Patients. Journal of Cardiac Surgery, 24, 256-259. https://doi.org/10.1111/j.1540-8191.2008.00797.x
[33]
Patil, N.P., Dutta, N., Satyarthy, S., Geelani, M.A., Satsangi, D.K. and Banerjee, A. (2011) Cardiac Myxomas: Experience over One Decade. Journal of Cardiac Surgery, 26, 355-359. https://doi.org/10.1111/j.1540-8191.2011.01271.x
