Multiple cardiac myxomas with pulmonary arterial obstruction and acute right heart failure

Abstract

Multiple myxomas in the ventricles, causing pulmonary obstruction, are extremely uncommon. We treated multiple myxomas, seemingly clinically malignant, which had caused acute right heart failure due to their position in the outlet of the right ventricle. The position of the myxomas obstructed the pulmonary artery. To prevent the right heart from failing, we proceeded with tumor resection with the cardiopulmonary bypass on a beating heart and added cryoablation. Following the removal of the tumor, symptoms improved drastically. The postoperative course was uneventful.

Molecular Basis of Cardiac Myxomas

“…Right atrial myxomas can embolize to pulmonary vessels and produce signs of pulmonary hypertension [47]. Large ventricular myxomas can produce signs and symptoms of pulmonary and aortic valvular stenosis [48]. …”

Right ventricular myxoma: A case report

“…Only sporadic cases of myxomas arising from the right ventricular outflow tract have been reported in the literature [5][6][7] . In a series of 81 myxomas operated in our institution during the period of 29 years, this is the first patient with right ventricular myxoma.…”

Myxoma of right ventricular outflow tract with pulmonary artery obstruction

“…Around 80% of the myxomas are localized to the left atrium. Reports of myxomas arising from the right ventricular outflow tract are extremely rare and up to now only few cases have been reported in the literature [1][2][3][4][5] and in some cases the tumors were multiple or biventricular 1,2 . In majority of cases the presentation was acute, either in form of acute right ventricular failure 1 or multiple syncopal attacks or cardiac arrest 3 .…”

“…They are rarely found in the ventricles. Myxomas in the Right Ventricular Outflow Tract (RVOT) are very rarely reported [1][2][3][4][5] . We present one such case where the myxoma was arising from the right ventricular outflow tract, partially involving the pulmonary valve and causing obstruction of the right ventricular outflow tract.…”