Biatrial approach to cardiac myxomas: A 30-year clinical experience

Jones, David R.; Warden, Herbert E.; Murray, Gordon F.; Hill, Ronald C.; Graeber, Geoffrey M.; Cruzzavala, Jose; Gustafson, Robert A.; Vasilakis, A

doi:10.1016/0003-4975(95)00064-r

Cited by 82 publications

(75 citation statements)

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“…The biatrial approach for these 2) It is now the most widely accepted method for excision of atrial myxoma since it has advantages of identification of the site of attachment, minimal manipulation and prevention of embolism of the tumor, adequate margins of excision, inspection of the four cardiac chambers, and secure closure of the iatrogenic atrial septal defect. [3][4][5][6] In the present case, surgical en-bloc resection and pathological complete resection of the tumor were accomplished using a biatrial approach. In surgery for atrial myxomas, it is important to select a method of atrial reconstruction that corresponds to the area of the iatrogenic atrial defect.…”

Section: Discussionmentioning

confidence: 95%

Extensive Resection and Double-Patch Reconstruction for Left Atrial Myxoma

Morokuma

Katayama

Kamohara

et al. 2014

ATCS

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The efficacy and safety of surgical intervention for atrial myxoma are established, but the operative approach to tumor resection and atrial reconstruction are controversial. A biatrial approach is generally used for excision of atrial myxoma and has many advantages. In contrast, there are a few reports about the method of double-patch reconstruction, and the right and left atrium are individually reconstructed with the two patches. We found it to be effective in the case reported here. We suggest that this method can be applied to atrial myxoma in which extensive resection is necessary.

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Section: Discussionmentioning

confidence: 95%

Extensive Resection and Double-Patch Reconstruction for Left Atrial Myxoma

Morokuma

Katayama

Kamohara

et al. 2014

ATCS

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Since then, many approaches have been described in the literature, such as left atriotomy, right atriotomy and biatrial approach. [11][12][13][14][15][16][17][18][19] In our series, the approaches used for left atrial myxomas are left atriotomy in 73.6% (n=145), right atriotomy in 13.7% (n=27), and biatrial approach in 12.7% patients (n=25). Based on our findings, we found that the left atriotomy approach was much more convenient, simple, rapid, and safe approach for the excision of the left atrial myxomas.…”

Section: Discussionmentioning

confidence: 99%

“…To prevent recurrence, there is a consensus that surgical excision must include a substantial portion of the normal endocardium near the base of implantation. [16][17][18][19] Recurrence can be due to inadequate resection, intraoperative implantation, embolization or multi-centric growth. [5,6] In our series, the recurrence rate was 3.1%, which is comparable to the international standard of 5%.…”

Section: Discussionmentioning

confidence: 99%

“…[5,6] In our series, the recurrence rate was 3.1%, which is comparable to the international standard of 5%. [16,17,19] The recurrence was mainly found in left atrial myxomas, excised through right atriotomy approach, probably due to inadequate excision or intraoperative implantation. In one case of multiple myxomas, recurrence was seen at a different location, probably due to the multi-centric growth.…”

Section: Discussionmentioning

confidence: 99%

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Cardiac Myxomas: Clinical spectrum, investigation findings, and surgical treatment based on our 25-year-experiences

Gajjar¹

2017

Cardiovasc Surg Int

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patients (99 males, 130 females; mean age 37.1 years; range 7 to 63 years) with a primary or recurrent intra-cardiac myxoma underwent surgical excision at our institute. The diagnosis was made by transthoracic and transesophageal echocardiography. The basic surgical principle of complete wide excision was applied, and either unicameral (right or left atrial approach) or bicameral (both atria opened) surgical approach was used. Myxomas originating from the valve or valve annulus required a special attention. Postoperative echocardiograms were obtained in all patients before discharge. All patients were followed at three and 18 months, and five years postoperatively. Results:The most common presenting symptoms were dyspnea and palpitation. There were 197 left atrial, 27 right atrial, two left ventricular, and one each of right ventricular, right ventricular outflow tract and multiple myxomas. There were three early death events; however no late mortality was seen. During follow-up, all patients were in the New York Heart Association Class I and echocardiography showed good ventricular functions with normal pulmonary artery pressure. Seven patients developed sporadic recurrence of myxoma. The valves were competent in the patients who underwent valve repair. Conclusion:Based on our experience, we recommend the left atriotomy approach for left atrial myxomas and the right atriotomy approach for dumbbell-shaped left atrial and right atrial myxomas. Biatrial approach should be used in large and unusually located left atrial myxomas, while individualized approaches should be performed for others. To prevent recurrence, the surgical excision must include a substantial portion of normal endocardium near the base of implantation. The early mortality is commonly seen due to coronary embolism, and the late survival of patients after myxoma excision is usually excellent.

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“…Para eliminar completamente un mixoma de la AI se emplea un abordaje biatrial (7), cortando todo el espesor del septum interauricular cuando el tumor está fijado en la región de la fosa oval. El mixoma resecado tenía aspecto morulado, lo cual se asocia de forma significativa a eventos embólicos (8) (Fig. 2B).…”

Section: Discussionunclassified

Ictus isquémico secundario a mixoma auricular izquierdo

Portero

Javier

Pareja

et al. 2007

An. Med. Interna (Madrid)

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INTRODUCCIÓNEl mixoma es una rara causa a considerar de ictus y accidente isquémico transitorio, que afecta fundamentalmente a pacientes jóvenes de sexo femenino (1). La embolización al sistema nervioso central supone alrededor del 50% de los sucesos embólicos causados por mixomas de aurícula izquierda (AI), en ocasiones representa la primera manifestación sintomática, es más común en el hemisferio izquierdo, puede ser múltiple y masiva y con una instauración del déficit neuroló-gico gradual o repentina (2). El tratamiento es quirúrgico y el pronóstico a largo plazo excelente, si bien, los focos de metás-tasis viables resultantes de la embolización, así como los aneurismas vasculares secundarios, pueden producir síntomas años después. CASO APORTADOMujer de 43 años con antecedentes de cefaleas y tabaquismo. Desde hace un año presentaba episodios de visión borrosa, notando en alguna ocasión pérdida visual en hemicampo derecho, acompañándose de cefaleas que cedían tras tratamiento analgésico. Hace nueve meses presentó episodio ictal transitorio hemisférico izquierdo, que desapareció pasados 30 minutos.En la mañana del presente ingreso notó torpeza en la mano derecha, desviación de la comisura bucal y dificultad para la articulación de la palabra. Por este motivo acudió a urgencias, siendo valorada por el neurólogo que objetivó paresia facial supranuclear derecha y leve disartria, inestabilidad de miembro superior derecho con torpeza para movimientos finos e hipoestesia táctil y algésica facio-braquial derecha. En urgencias se realizó ECG, en ritmo sinusal, TAC craneal que inicialmente no mostró signos de infarto y Doppler de [0212-7199 (2007) RESUMENPresentamos el caso de una mujer de 43 años, ingresada por infarto isquémico en el territorio de la arteria cerebral media izquierda y con antecedentes de episodios ictales. Tras una serie de pruebas se realiza una ecocardiografía que muestra un mixoma auricular izquierdo como etiología del ictus. Ante la necesidad de exéresis quirúrgica, se solicita una resonancia magnética (RNM) cardiaca para obtener información adicional sobre la anatomía y morfología de la masa auricular.Se exponen las manifestaciones neurológicas del mixoma cardiaco, siendo el accidente cerebrovascular la presentación más frecuente, tal y como ilustra el caso clínico.

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Biatrial approach to cardiac myxomas: A 30-year clinical experience

Cited by 82 publications

References 1 publication

Extensive Resection and Double-Patch Reconstruction for Left Atrial Myxoma

Extensive Resection and Double-Patch Reconstruction for Left Atrial Myxoma

Cardiac Myxomas: Clinical spectrum, investigation findings, and surgical treatment based on our 25-year-experiences

Ictus isquémico secundario a mixoma auricular izquierdo

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