Surgical Treatment of Cardiac Myxomas: A 23-Case Experience

Gür, Ali Kemal; Aykaç, Mehmet Coşkun

doi:10.1532/hsf.1987

Cited by 8 publications

(3 citation statements)

References 13 publications

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“…Data published over the past decades show excellent overall outcomes in operative mortality, short- and long-term survival and tumour recurrence[ 4 , 101 - 118 ]. Surgical excision of 23 myxomas in Turkey between 2010 and 2017 showed excellent outcomes with no early or late mortality[ 112 ]. A 16-year single centre study from China reported no need for secondary surgery in 97.4% ± 2.5% of cases after 10 years.…”

Section: Treatmentmentioning

confidence: 99%

Cardiac myxomas: A narrative review

Islam¹

2022

WJC

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Cardiac myxomas are common primary neoplasms of the heart. They are biologically benign but “functionally malignant” because of the potential for embolization. They arise most commonly from the left atrium, but no chambers of the heart are immune. They may be sporadic in the majority but also familial as a part of the Carney complex. Two morphological forms exist: polypoid and papillary. Polypoid myxomas often present with obstructive features, while the papillary forms are more prone to embolization. Histogenesis is still controversial; the current view centres around origin from the primitive pluripotent mesenchymal cells. They may be of giant proportion, be calcified or get infected. Clinical presentation typically involves the triad of intracardiac obstruction, embolic events and constitutional symptoms. Precordial examination findings may simulate those of mitral or tricuspid stenosis. The presence of tumour plop and change of the physical findings with changing position may help differentiation between the two. Echocardiography is the investigation of choice. Echogenic polypoid or papillary mobile mass within the atrial cavity remaining attached to the interatrial septum through a stalk are the tell-tale echocardiographic features. Cardiac magnetic resonance and computed tomographic scanning may have incremental diagnostic value. Histopathological examination reveals abundant loose myxoid stroma with scattered round, polygonal or stellate cells with dense irregular nuclei. Genetic testing may detect mutations in the PRKAR1A gene in the familial form of cardiac myxoma, i.e. the Carney complex. Surgical excision is the mainstay of treatment with low operative mortality, excellent postoperative survival and low recurrence rate. The current trend favours minimal-access surgery with or without robotic assistance. Physicians should have appropriate preparedness to make a timely diagnosis and enthusiastic treatment to avoid potentially fatal complications.

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Section: Treatmentmentioning

confidence: 99%

Cardiac myxomas: A narrative review

Islam¹

2022

WJC

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“…The treatment of cardiac myxomas is eminently surgical; medical treatment is currently non-existent [ 36 ]. The objective is the removal of the tumoral formation and the adjacent healthy tissue as soon as the diagnosis has been established, to avoid adjacent complications (obstructive and emboligenic) [ 37 ]. For patients over 50 years of age, who do not have a family history of the disease, the elective treatment is simple surgical excision; however, for young patients with significant family history, the treatment is complex and aggressive [ 38 , 39 ].…”

Section: ⧉ Treatmentmentioning

confidence: 99%

Giant left atrial myxoma – literature review and case presentation

Raicea¹,

Suciu²,

Raicea³

et al. 2022

Rom J Morphol Embryol

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Primary cardiac tumors are an extremely rare pathology, representing only 5-10% of cardiac neoplasms, but among them, the most common are cardiac myxomas, that appear to originate from multipotent mesenchymal cells of the subendocardial and endocardial stroma. The incidence of cardiac myxomas is higher in females and they are usually diagnosed between the fourth and sixth decade of life. Most often, they are located in the left atrium, having the site of attachment at the level of the interatrial septum, especially at the level of the fossa ovalis and the adjacent limbus. Due to the increased risk of systemic embolization and intracardiac obstruction, cardiac myxomas have a definite indication for emergency surgical treatment. Cardiac myxomas are a very rare cause of transient ischemic attacks and stroke. We present the case of a 38-year-old patient who experienced four recurrent transient ischemic attacks and strokes. At the fourth cerebrovascular event, echocardiography was performed and it revealed a giant tumor located in the left atrium that was surgically removed. Pathological examination confirmed the diagnosis of cardiac myxoma. The postoperative evolution was favorable, both from a neurological and cardiac point of view. Although cardiac myxomas represent a rare cause of transient ischemic attacks and stroke, they must be considered as part of the assessment protocol for cerebrovascular events.

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“…The 30-day mortality rate after CM excision was reported to range between 0% and 10%, and the recurrence rate during long -term follow -up was 0% to 7.4% (TABLE 4). [4][5][6]8,11,22,23 The number of patients operated in different studies may explain the wide ranges of 30-day mortality and recurrence rates during follow -up. Most studies on small patient samples have higher mortality accessed through the tricuspid or aortic valve or incision in the anterior wall of the right ventricle.…”

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confidence: 99%

Current challenges in the diagnosis and treatment of cardiac myxoma

Samanidis¹,

Khoury²,

Balanika³

et al. 2020

Kardiol Pol

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Methods This review is based on research of the current literature regarding the epidemiology of CM, its clinical presentation, diagnosis, and treatment. The PubMed database was searched for eligible studies and the search was restricted to the years 2000 to 2019. The search term was "cardiac myxoma" and we included observational or retrospective studies with large samples of patients who were treated for CM only. In addition, the data of interest to the present review were long-term follow-up, the recurrence rate during follow-up, and the survival rate after CM resection. Additionally, we looked for studies on novel surgical techniques for CM resection and those describing unusual CM location or clinical presentation. The primary source for data extraction were 24 articles from 15 countries, which reported on a total of 2205 patients with CM (TABLE 1). 1-24 We included studies from Europe, North and South America,

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Surgical Treatment of Cardiac Myxomas: A 23-Case Experience

Cited by 8 publications

References 13 publications

Cardiac myxomas: A narrative review

Cardiac myxomas: A narrative review

Giant left atrial myxoma – literature review and case presentation

Current challenges in the diagnosis and treatment of cardiac myxoma

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