Surgical Removal of an Intracavitary Left Ventricular Myxoma

Kay, Jerome Harold; Anderson, Robert M.; Meihaus, John E.; Lewis, Reuben R.; Magidson, Oscar; Bernstein, Sol; Griffith, George C.

doi:10.1161/01.cir.20.5.881

Cited by 33 publications

(14 citation statements)

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“…The first documentation of a surgical case of a left ventricle myxoma excision was made by Kay et al [7] in 1959. By 2014 at least 71 surgical cases of left myxoma were reported (excluding mitral or aortic valve myxomas), the majority of them being individual cases [7].…”

Section: Discussionmentioning

confidence: 99%

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Left Ventricular Myxoma: Case Report

Luiz¹,

Mauro²,

Isabela³

et al. 2018

JPP

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Section: Discussionmentioning

confidence: 99%

“…By 2014 at least 71 surgical cases of left myxoma were reported (excluding mitral or aortic valve myxomas), the majority of them being individual cases [7].…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Myxoma: Case Report

Luiz¹,

Mauro²,

Isabela³

et al. 2018

JPP

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“…1 Since then, at least 71 other surgical cases (excluding myxomas of the mitral or aortic valve) have been reported, most of them as single cases (Table I). Most medical centers have little or no experience in the management of a myxoma in the left ventricle.…”

Section: Discussionmentioning

confidence: 99%

Myxoma of the Left Ventricle

Abad

Nóvoa

Delgado

et al. 2014

Texas Heart Institute Journal

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Myxoma of the Left VentricleThis report concerns a 69-year-old Case ReportA 69-year-old woman with known chronic liver disease was admitted for acute liver dysfunction in association with nonspecific autoimmune disease, rheumatoid arthritis, hypothyroidism, and arterial hypertension. She reported no cardiac diseases or chest pain. During her hospitalization, transthoracic and transesophageal echocardiograms showed a single pediculated round mass (13 × 23 mm) attached to the left ventricular endocardium (Figs. 1 and 2). Chest radiographs, the electrocardiogram, and standard blood tests all showed normal findings. The patient's body mass index was 26.24 kg/ m 2 . A liver function test yielded normal results except for a moderate increase of serum glutamic-oxaloacetic transaminase (93 U/L) and serum glutamic-pyruvic transaminase (92 U/L), as determined by enzymatic and colorimetric spectrophotometry.The patient underwent excision of the intracardiac mass on 5 May 2010, under general anesthesia. A median sternotomy was performed. The ascending aorta and both venae cavae were cannulated, and standard cardiopulmonary bypass (CPB) was performed. The heart was stopped by cross-clamping the ascending aorta. Myocardial protection was achieved by means of topical cooling with ice and intermittent anterograde and retrograde administration of cold-blood cardioplegic solution. The venae cavae were snared with tourniquets, the tumor was excised through a limited left ventriculotomy, and the tumor's pedicle was shaved from the endocardium. The incision was closed with a double layer of 3-0 polypropylene running suture (Fig. 3). The patient was weaned from CPB easily, without inotropic support. Under histopathologic examination, the excised mass was consistent with myxoma. A follow-up echocardiogram 3 months postoperatively disclosed no abnormalities. The patient was lost to follow-up. DiscussionThe first reported case of surgical removal of a left ventricular myxoma was that published by Kay and colleagues in 1959.1 Since then, at least 71 other surgical cases (excluding myxomas of the mitral or aortic valve) have been reported, most of them as single cases (Table I). Most medical centers have little or no experience in the management of a myxoma in the left ventricle. The surgical approach to a tumor in this location can be carried out 1) through the left atrium and mitral valve, 2) through the ascending aorta, with video assistance, 3) through the right atrium and atrial septum, or 4) through a small longitudinal incision in the left ventricle. We decided on this last approach because it affords good visibility and the possibility of a complete resection. Most reported excisions of left ventricular myxoma have been performed with use of full median sternotomy and classical CPB. Recently, endoscopy and minimally invasive techniques have also been applied.

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“…Los fenómenos embólicos, el síncope y los soplos sistólicos por obstrucción del TSVI, son las manifestaciones clínicas más frecuentes del mixoma ventricular izquierdo 6 , aunque muy ocasionalmente puede asociarse a arritmias cardiacas 7 . Pero, la complicación más frecuente es la embolia sistémica que puede incluso provocar obstrucción de la aorta abdominal y arterias renales 8,9 . El mixoma ventricular izquierdo en nuestra paciente se descubrió de manera incidental mediante Eco2D, solicitado para la evaluación de un soplo sistólico pesquisado en un control rutinario de su hipertensión arterial.…”

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Mixoma ventricular izquierdo asintomático diagnosticado circunstancialmente por ecocardiografía

Díaz

Aranguiz

2013

Rev. méd. Chile

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We report a 50 year-old hypertensive and asymptomatic woman in whom a left ventricular tumor was found on a routine two-dimensional. La sintomatología depende de su localización, aunque ocasionalmente no producen síntomas y su pesquisa es posible por el uso cada vez más frecuente de la ecocardiografía 3,4 . Caso clínicoMujer de 50 años, hipertensa, asintomática. En control ambulatorio rutinario se solicitó un ecocardiograma bidimensional transtorácico (Eco2D), luego de la auscultación de un soplo sistólico III/VI en el foco aórtico. El Eco2D reveló la existencia de una masa móvil al interior del ventrículo izquierdo de 5,0 x 1,3 cm, adherida al septum interventricular, con zonas de intensidad aumentada, sugerentes de calcificación (Figura 1, panel A), que provocaba una obstrucción parcial del tracto de salida del ventrículo izquierdo (TSVI), con gradiente máxima de 26 mmHg (Figura 1, panel B). No se observaron tumores adicionales en ninguna otra cámara cardiaca y los exámenes de laboratorio, radiografía de tórax y electrocardiograma resultaron normales. Para una mejor evaluación de la masa intraventricular, se realizó ecocardiografía tridimensional (Eco 3D), que permitió identificar la morfología multilobular del tumor, objetivándose -además-que ocupaba 65% del TSVI (Figura 1, panel C y D). Para complementar la evaluación, se efectuó resonancia cardiaca (RC) que mostró un tumor con señal isointensa respecto del tejido miocárdico y un pedúnculo de anclaje de 2 cm adherido al tercio superior del septum interventricular superior, que no interfería con el normal funcionamiento del aparato subvalvular mitral (Figura 1, panel E). En la imagen de inversión/recuperación posterior

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Surgical Removal of an Intracavitary Left Ventricular Myxoma

Cited by 33 publications

References 1 publication

Left Ventricular Myxoma: Case Report

Left Ventricular Myxoma: Case Report

Myxoma of the Left Ventricle

Mixoma ventricular izquierdo asintomático diagnosticado circunstancialmente por ecocardiografía

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