Primary Cardiac Tumours - Operative Treatment of 20 Patients

Abstract

This report describes a series of 20 patients operated on for a primary cardiac tumour. The majority of the tumours (16) were benign myxomas; 12 of them were located in the left atrium, two in the right atrium and two were biatrial. Two lipomas were found; one was epicardial and the other was located in the left atrium. The only intraventricular tumour was a malignant left ventricular myosarcoma. The propensity of intracardiac tumours to embolize was distinctive. Nine of the 16 myxomas presented with peripheral embolization, and in two patients surgery was complicated by fatal perioperative cerebral embolization of myxomatous tissue. Furthermore, in one patient embolization of a left atrial lipoma necessitated amputation of her left arm before cardiac surgery. Late postoperative recurrences were found in two patients with atrial myxomas. In one of them, reoperation showed that the tumour had grown at that site in the interatrial septum where the original pedicle had been excised. One patient developed severe mitral valve regurgitation and underwent replacement with a prosthetic valve at reoperation. Otherwise our late follow-up study showed that the results of surgery were usually excellent even though mild echocardiographic abnormalities were not uncommon. Our experience emphasizes the embolic potential of intracardiac myxomas and suggests, furthermore, that to avoid recurrences excisions with wide margins should be preferred. Echocardiography is an optimal method for the follow-up of these patients.

Fatty lesions of the atria and interatrial septum

“…These tumors are rare benign lesions that have a predilection for the epicardial/pericardial surface [13]. However, intracardiac lipomas at the level of the atria or IAS do occur [14][15][16]. These lesions, like LHIS, are usually asymptomatic and cause symptoms depending on their size and location.…”

Diagnosis and Treatment of Cardiac Myxoma-Short Term Clinical Analysis of 14 Cases in a Single Hospital

“…Surgery should be careful and check all four-chamber of heart to prevent the omission [35]. Rinse thoroughly each chamber of the heart before the end of surgery to prevent embolism.…”

Left Atrial Myxoma: A Rare Nonatherosclerotic Cause of Acute Myocardial Infarction

“…The majority of these tumors are benign myxomas located in the left atrium (80%) [2]. Rare coronary artery embolization from a cardiac myxoma usually involves either the right coronary artery (RCA) or the left anterior descending (LAD) coronary artery [3].…”