Author(s): Jyoti Prasad Kalita1, Manuj Kumar Saikia2, Mohd. Yunus3, Amit Malviya4, Manish Kapoor5, Animesh Mishra6, Pravin Jha7, Chandra Kumar Das8
Cardiac myxomas are the most common primary cardiac tumors. A high degree of suspicion is required for diagnosing myxomas clinically and often leads to grave consequence if missed. Though surgical resection is the definitive treatment, but if not treated with the right surgical technique recurrence occurs.
To describe clinical presentations, age and sex distribution, anatomical location and morbidity, mortality and recurrence rate following surgery of patients of North Eastern part of India who have presented in our Cardiothoracic Unit with cardiac myxomas.
All consecutive patients over a period of 5 years who underwent surgical excision of cardiac myxoma at our Cardiothoracic Unit and histologically proven as cardiac myxoma were included in this study. Data were collected from the operation data base and the patient records. Echocardiography was the the diagnostic tool in all cases. The historical longitudinal study was performed. All patients underwent operation soon after the diagnosis of a myxoma was made. Complete tumour excision were done in all cases. All cases were followed up for a mean period of 32 months.
Of total 28 patients who underwent surgery for cardiac tumor over that period, 25(89.25%) patients had histologically proven cardiac myxomas. Their age ranged from 15 to 55 years with a mean of 35 years. Majority patients were female (n-16, 64%). Most of the patients had clinical presentations similar to obstructive mitral valve. A small group of patients presented with embolic and constitutional symptoms. All patients underwent operation via right atrial approach. Left atrium (n-20, 80%) is the commonest location followed by the right atrium (n-3, 12%). One patient had myxoma originating from tricuspid valve annulus, one from right ventricle and another one patient had mitral valve annulus origin. There was no death after surgery or recurrence was noted after mean 32 moths of follow-up.
DISCUSSION / CONCLUSION
High degree of suspicion for early diagnosis, prompt and right surgical technique is the key to deal with a myxoma patient to have a desired outcome with minimal complications.