Myxoma surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Maria Fernanda Villarreal, M.D. [2]Cafer Zorkun, M.D., Ph.D. [3] Ahmad Al Maradni, M.D. [4]

Overview

Surgery is the mainstay of treatment for cardiac myxoma. The feasibility of surgery depends on the patient hemodynamic stability at diagnosis. Cardiac myxoma surgery has an operative mortality around 0 to 3%, depending on risk factors or mechanical damage to a heart valve, as well as adhesion of the tumor to valve leaflets. The short and long-term prognosis is generally regarded as excellent.

Surgery

The mainstay treatment for cardiac myxomas is surgical removal. Urgent surgery should be performed because of the possibility of embolic complications or sudden death. Intraoperative fragmentation of the tumor and embolism must be avoided. In most cases, cardiac myxomas can be removed easily because they are sessile or pedunculated.

Surgical intervention is performed as follows:[1][2][3]

Pre-operative Evaluation

The feasibility of surgery depends on the patient hemodynamic stability at diagnosis.[4]

Prognosis

  • Cardiac myxoma surgery has an operative mortality around 0 to 3% depending on risk factors or mechanical damage to a heart valve, as well as adhesion of the tumor to valve leaflets (in some cases, valve repair by annuloplasty or replacement with a prosthetic valve is necessary).[2]
  • The short and long-term prognosis is generally regarded as excellent.

Complications

Supraventricular arrhythmias may follow surgical removal of atrial myxomas.[5]

Videos

Surgery of left atrial cardiac myxoma



References

  1. Berdajs DA, Ferrari E. Surgical treatment for heart myxomas. Multimed Man Cardiothorac Surg. 2012;2012:mms016.
  2. 2.0 2.1 Jain S, Maleszewski JJ, Stephenson CR, Klarich KW (2015). "Current diagnosis and management of cardiac myxomas". Expert Rev Cardiovasc Ther. 13 (4): 369–75. doi:10.1586/14779072.2015.1024108. PMID 25797902.
  3. Ipek G, Erentug V, Bozbuga N, Polat A, Guler M, Kirali K, Peker O, Balkanay M, Akinci E, Alp M, Yakut C (2005). "Surgical management of cardiac myxoma". J Card Surg. 20 (3): 300–4. doi:10.1111/j.1540-8191.2005.200415.x. PMID 15854102.
  4. Berdajs DA, Ferrari E. Surgical treatment for heart myxomas. Multimed Man Cardiothorac Surg. 2012;2012:mms016.
  5. Khan, MohammadShahbaaz; Sanki, ProkashK; Hossain, MohammadZ; Charles, Anup; Bhattacharya, Shubhankar; Sarkar, UdayN (2013). "Cardiac myxoma: A surgical experience of 38 patients over 9 years, at SSKM hospital Kolkata, India". South Asian Journal of Cancer. 2 (2): 83. doi:10.4103/2278-330X.110499. ISSN 2278-330X.

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