TITLE:
Six Years Clinical Experience and Surgical Considerations in Management of Cardiac Myxoma in Iraqi Center for Heart Disease—Single Center Experience
AUTHORS:
Hozhan Hussein Blbas, Abdulameer Mohsin Hussein, Muhammad Mahmud Salim, Laith Saleh Alkaaby, Abdulsalam Y. Taha
KEYWORDS:
Atrial Myxoma, Cardiac Tumors, Cardiac Surgery
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.12 No.8,
August
24,
2022
ABSTRACT: Background: Cardiac myxomas are the most frequently encountered benign cardiac tumors
that if left untreated are inexorably progressive and potentially fatal. Surgery
is the only way of treatment, and if not treated with the right surgical
technique recurrence occurs. Objectives: In this single center study we
documented the patterns of presentation, localization, surgical approaches and
outcome of cardiac myxomas. Methods: This is a retrospective study of 20
patients who underwent surgical removal of atrial myxoma from January 2010 to
December 2015. All patients underwent general investigations, and
echocardiography was performed on all patients and surgery was done using
extracorporeal circulation and mild hypothermia. Results: The ages of
the patients ranged from 14 years to 71 years, with a mean of 51.45 years. Most
myxomas (75%) originated from left atrium, 20% from right atrium and biatrial
in 5% of cases. The male-to-female ratio was 1:2.3 (14 females and 6 males).
Myxomas were more common in blood group A+ and B+. Chief complaints were dyspnea (70%) and palpitation
(50%). The majority of masses were attached to the interatrial septum
(65%) and four of cases (20%) arose from the lateral wall. Right atrial
trans-septal incision was used in 55% of cases. No recurrence was recorded in
our study. Six patients had postoperative complications, mainly in the form of
arrhythmia (3 cases), bleeding (0ne case) and renal failure (one case) which
resulted in the death of the patient. Conclusions: Cardiac myxoma
excision account for a very small percentage of cardiac procedures. Immediate
surgical treatment is indicated because of high risk of embolization and sudden
death. Cardiac myxomas can be excised with a low rate of mortality and
morbidity. Follow-up examination, including echocardiography, should be
performed regularly.