Myxoma surgery: Difference between revisions
Jump to navigation
Jump to search
| (9 intermediate revisions by 5 users not shown) | |||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Myxoma}} | {{Myxoma}} | ||
{{CMG}}; '''Associate Editor-In-Chief:''' {{ | {{CMG}}; '''Associate Editor-In-Chief:''' {{MV}}{{CZ}} {{AAM}} | ||
==Overview== | ==Overview== | ||
Surgery is the mainstay of treatment for cardiac myxoma. | [[Surgery]] is the mainstay of treatment for cardiac myxoma. The feasibility of [[surgery]] depends on the [[patient]] [[Hemodynamics|hemodynamic]] stability at [[diagnosis]]. Cardiac myxoma [[surgery]] has an operative [[mortality]] around 0 to 3%, depending on [[Risk factor|risk factors]] or mechanical damage to a [[heart valve]], as well as adhesion of the [[Tumor cell|tumor]] to [[valve]] leaflets. The short and long-term [[prognosis]] is generally regarded as excellent. | ||
==Surgery== | ==Surgery== | ||
The mainstay treatment for cardiac myxomas is surgical removal. Urgent surgery should be performed because of the possibility of embolic complications or sudden death. Intraoperative fragmentation of the tumor and embolism must be avoided. In most cases, cardiac myxomas can be removed easily because they are sessile or pedunculated. | The mainstay treatment for cardiac myxomas is surgical removal. [[Urgent care|Urgent]] surgery should be performed because of the possibility of [[embolic]] [[Complication (medicine)|complications]] or [[sudden death]]. Intraoperative fragmentation of the [[Tumor cell|tumor]] and [[embolism]] must be avoided. In most cases, cardiac myxomas can be removed easily because they are [[sessile]] or [[pedunculated]]. | ||
Surgical intervention is performed as follows:<ref name="pmid15854102">{{cite journal |vauthors=Ipek G, Erentug V, Bozbuga N, Polat A, Guler M, Kirali K, Peker O, Balkanay M, Akinci E, Alp M, Yakut C |title=Surgical management of cardiac myxoma |journal=J Card Surg |volume=20 |issue=3 |pages=300–4 |year=2005 |pmid=15854102 |doi=10.1111/j.1540-8191.2005.200415.x |url=}}</ref> | Surgical intervention is performed as follows:<ref>Berdajs DA, Ferrari E. Surgical treatment for heart myxomas. Multimed Man Cardiothorac Surg. 2012;2012:mms016.</ref><ref name="pmid25797902">{{cite journal |vauthors=Jain S, Maleszewski JJ, Stephenson CR, Klarich KW |title=Current diagnosis and management of cardiac myxomas |journal=Expert Rev Cardiovasc Ther |volume=13 |issue=4 |pages=369–75 |year=2015 |pmid=25797902 |doi=10.1586/14779072.2015.1024108 |url=}}</ref><ref name="pmid15854102">{{cite journal |vauthors=Ipek G, Erentug V, Bozbuga N, Polat A, Guler M, Kirali K, Peker O, Balkanay M, Akinci E, Alp M, Yakut C |title=Surgical management of cardiac myxoma |journal=J Card Surg |volume=20 |issue=3 |pages=300–4 |year=2005 |pmid=15854102 |doi=10.1111/j.1540-8191.2005.200415.x |url=}}</ref> | ||
*The [[Tumor cell|tumor]] is excised with the use of mild general and deep topical [[hypothermia]], cardioplegic [[cardiac arrest]], and [[cardiopulmonary bypass]]. | |||
*[[Median sternotomy]] | |||
*Removal of myxoma: Cardiac chambers should be inspected to rule out a multifocal [[Tumor cell|tumor]]. | |||
*Removal of surrounding [[atrial septum]]: The root of the pedicle and the full thickness of the adjacent [[Interatrial septum|interatrial septu]]<nowiki/>m should be excised, resulting in an [[atrial septal defect]]. | |||
*[[ASD|Atrial septum defect]] repair - can be closed by direct suturing or, if too large, with a pericardial or Dacron patch. | |||
==Pre-operative Evaluation== | ==Pre-operative Evaluation== | ||
| Line 23: | Line 23: | ||
==Prognosis== | ==Prognosis== | ||
Cardiac myxoma surgery has an operative mortality around 0 to 3% depending on risk factors or mechanical damage to a heart valve, as well as adhesion of the tumor to valve leaflets (in some cases, valve repair by annuloplasty or replacement with a prosthetic valve is necessary).<ref name="pmid25797902">{{cite journal |vauthors=Jain S, Maleszewski JJ, Stephenson CR, Klarich KW |title=Current diagnosis and management of cardiac myxomas |journal=Expert Rev Cardiovasc Ther |volume=13 |issue=4 |pages=369–75 |year=2015 |pmid=25797902 |doi=10.1586/14779072.2015.1024108 |url=}}</ref> The short and long-term prognosis is generally regarded as excellent. | * Cardiac myxoma surgery has an operative mortality around 0 to 3% depending on risk factors or mechanical damage to a heart valve, as well as adhesion of the tumor to valve leaflets (in some cases, valve repair by [[annuloplasty]] or replacement with a [[Prosthetic valves|prosthetic valve]] is necessary).<ref name="pmid25797902">{{cite journal |vauthors=Jain S, Maleszewski JJ, Stephenson CR, Klarich KW |title=Current diagnosis and management of cardiac myxomas |journal=Expert Rev Cardiovasc Ther |volume=13 |issue=4 |pages=369–75 |year=2015 |pmid=25797902 |doi=10.1586/14779072.2015.1024108 |url=}}</ref> | ||
* The short and long-term prognosis is generally regarded as excellent. | |||
==Complications== | ==Complications== | ||
Supraventricular arrhythmias may follow surgical removal of atrial myxomas. | [[Supraventricular arrhythmias]] may follow surgical removal of [[atrial]] myxomas.<ref name="KhanSanki2013">{{cite journal|last1=Khan|first1=MohammadShahbaaz|last2=Sanki|first2=ProkashK|last3=Hossain|first3=MohammadZ|last4=Charles|first4=Anup|last5=Bhattacharya|first5=Shubhankar|last6=Sarkar|first6=UdayN|title=Cardiac myxoma: A surgical experience of 38 patients over 9 years, at SSKM hospital Kolkata, India|journal=South Asian Journal of Cancer|volume=2|issue=2|year=2013|pages=83|issn=2278-330X|doi=10.4103/2278-330X.110499}}</ref> | ||
==Videos== | ==Videos== | ||
{| | {| | ||
| Line 42: | Line 43: | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] | |||
[[Category:Cardiology]] | |||
[[Category:Surgery]] | |||
Latest revision as of 14:21, 21 May 2020
|
Myxoma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Myxoma surgery On the Web |
|
American Roentgen Ray Society Images of Myxoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Maria Fernanda Villarreal, M.D. [2]Cafer Zorkun, M.D., Ph.D. [3] Ahmad Al Maradni, M.D. [4]
Overview
Surgery is the mainstay of treatment for cardiac myxoma. The feasibility of surgery depends on the patient hemodynamic stability at diagnosis. Cardiac myxoma surgery has an operative mortality around 0 to 3%, depending on risk factors or mechanical damage to a heart valve, as well as adhesion of the tumor to valve leaflets. The short and long-term prognosis is generally regarded as excellent.
Surgery
The mainstay treatment for cardiac myxomas is surgical removal. Urgent surgery should be performed because of the possibility of embolic complications or sudden death. Intraoperative fragmentation of the tumor and embolism must be avoided. In most cases, cardiac myxomas can be removed easily because they are sessile or pedunculated.
Surgical intervention is performed as follows:[1][2][3]
- The tumor is excised with the use of mild general and deep topical hypothermia, cardioplegic cardiac arrest, and cardiopulmonary bypass.
- Median sternotomy
- Removal of myxoma: Cardiac chambers should be inspected to rule out a multifocal tumor.
- Removal of surrounding atrial septum: The root of the pedicle and the full thickness of the adjacent interatrial septum should be excised, resulting in an atrial septal defect.
- Atrial septum defect repair - can be closed by direct suturing or, if too large, with a pericardial or Dacron patch.
Pre-operative Evaluation
The feasibility of surgery depends on the patient hemodynamic stability at diagnosis.[4]
Prognosis
- Cardiac myxoma surgery has an operative mortality around 0 to 3% depending on risk factors or mechanical damage to a heart valve, as well as adhesion of the tumor to valve leaflets (in some cases, valve repair by annuloplasty or replacement with a prosthetic valve is necessary).[2]
- The short and long-term prognosis is generally regarded as excellent.
Complications
Supraventricular arrhythmias may follow surgical removal of atrial myxomas.[5]
Videos
| 4B7Xs3QEIkg}}
Surgery of left atrial cardiac myxoma |
|---|
References
- ↑ Berdajs DA, Ferrari E. Surgical treatment for heart myxomas. Multimed Man Cardiothorac Surg. 2012;2012:mms016.
- ↑ 2.0 2.1 Jain S, Maleszewski JJ, Stephenson CR, Klarich KW (2015). "Current diagnosis and management of cardiac myxomas". Expert Rev Cardiovasc Ther. 13 (4): 369–75. doi:10.1586/14779072.2015.1024108. PMID 25797902.
- ↑ Ipek G, Erentug V, Bozbuga N, Polat A, Guler M, Kirali K, Peker O, Balkanay M, Akinci E, Alp M, Yakut C (2005). "Surgical management of cardiac myxoma". J Card Surg. 20 (3): 300–4. doi:10.1111/j.1540-8191.2005.200415.x. PMID 15854102.
- ↑ Berdajs DA, Ferrari E. Surgical treatment for heart myxomas. Multimed Man Cardiothorac Surg. 2012;2012:mms016.
- ↑ Khan, MohammadShahbaaz; Sanki, ProkashK; Hossain, MohammadZ; Charles, Anup; Bhattacharya, Shubhankar; Sarkar, UdayN (2013). "Cardiac myxoma: A surgical experience of 38 patients over 9 years, at SSKM hospital Kolkata, India". South Asian Journal of Cancer. 2 (2): 83. doi:10.4103/2278-330X.110499. ISSN 2278-330X.