Left Atrial Myxoma in a Child: An Uncommon Presentation of a Rare Tumour in Early Age

Maruf, MF; Akter, T; Islam, F; Chowdhury, Anindya Roy; Khan, JH; Hassan, K; Hosain, SN; Ahsan, NAK

doi:10.3329/cardio.v4i2.10462

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“…The diagnosis and management can be challenging in terms of the nature of the intracardiac mass, timing of delivery, necessity of cardiac surgery and risks of subsequent treatment [ 36 ] . The clinical manifestations of a cardiac myxoma can be one or more of the Goodwin's triad [ 51 ] . Patients may present with fatigue and dyspnea, which, however, can be misinterpreted as asthma or normal fatigue associated with pregnancy [ 39 ] .…”

Section: Discussionmentioning

confidence: 99%

Cardiac myxoma in pregnancy: a comprehensive review

Yuan¹

2015

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveCardiac myxoma in pregnancy is rare and the clinical characteristics of this entity have been insufficiently elucidated. This article aims to describe the treatment options and the risk factors responsible for the maternal and feto-neonatal prognoses.MethodsA comprehensive search of the literature of cardiac myxoma in pregnancy was conducted and 44 articles with 51 patients were included in the present review.ResultsTransthoracic echocardiography was the most common diagnostic tool for the diagnosis of cardiac myxoma during pregnancy. Cardiac myxoma resection was performed in 95.9% (47/49); while no surgical resection was performed in 4.1% (2/49) patients (P=0.000). More patients had an isolated cardiac myxoma resection in comparison to those with a concurrent or staged additional cardiac operation [87.2% (41/47) vs. 12.8% (6/47), P=0.000]. A voluntary termination of the pregnancy was done in 7 (13.7%) cases. In the remaining 31 (60.8%) pregnant patients, cesarean section was the most common delivery mode representing 61.3% and vaginal delivery was more common accounting for 19.4%. Cardiac surgery was performed in the first, second and third trimester in 5 (13.9%), 14 (38.9%) and 17 (47.2%) patients, respectively. No patients died. In the delivery group, 20 (76.9%) neonates were event-free survivals, 4 (15.4%) were complicated and 2 (7.7%) died. Neonatal prognoses did not differ between the delivery modes, treatment options, timing of cardiac surgery and sequence of cardiac myxoma resection in relation to delivery.ConclusionThe diagnosis of cardiac myxoma in pregnancy is important. Surgical treatment of cardiac myxoma in the pregnant patients has brought about favorable maternal and feto-neonatal outcomes in the delivery group, which might be attributable to the shorter operation duration and non-emergency nature of the surgical intervention. Proper timing of cardiac surgery and improved cardiopulmonary bypass conditions may result in even better maternal and feto-neonatal survivals.

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Section: Discussionmentioning

confidence: 99%