HEART SURGERY FOR PRIMARY CARDIAC TUMOR LEFT ATRIAL MYXOMA
- drpavankumar
- 0
- on Jun 08, 2017
HEART SURGERY FOR PRIMARY CARDIAC TUMOR LEFT ATRIAL MYXOMA AT LILAVATI HOSPITAL, MUMBAI , INDIA BY DR. PAVAN KUMAR
Mrs. L. N. 57 year foreign National from MOZAMBIQUE came to Lilavati hospital for general body check up for her mildly swollen right leg & mild off & on Fever. Her total body check up revealed no abnormalities except the cardiac Echo which showed 3.5 x 3.5 cm Globular Mass in left atrium attached to inter-atrial septum in an otherwise normal cardiac parameters. For differentiation a CARDIAC MRI was done which suggested that this mass could be Myxoma like Tumor rather than clot.
In view of these findings , the patient was advised urgent open heart surgery for removal of this tumor from Left atrium chamber of heart. Open heart surgery was carried out on 19/05/2017.Tumor was removal through Trans -atrial approach from right atrium. Tumor was 3.5 x 4.5 cm Globular hard mass attach to left atrial side of interatrial septum with broad base which was also removed. Atrial Septal reconstruction was done using Dacron Patch & heart surgery was completed successfully.
Tumor was sent for histopathology which confirmed the diagnosis of MYXOMA TUMOR of heart. Patient recovered completely & discharged from Hospital after 6 days.
Discussion –
In my own last 25 yrs of surgical practice I have removed 27 such Myxomas from heart, 13 from left atrium , 8 from Right atrium , 3 biatrial , 1 from right ventricle & 1 from Left ventricle successfully. So far no recurrence have been reported to me. Almost 50% have had embolic episodes , only 20% were asymptomatic patients.
Myxoma are pedunculated tumors with fibro muscular stalk attached to sub endothelial base usually at fossa ovalis on Inter Atrial Septum. These tumors have gelatinous appearance with foci of haemorrhage & calcification / cystic changes seen on histopathology which also shows uniform spindle / stellate – shape cells in extensive Myxoid stroma. Treatment for cardiac Myxoma tumors is prompt surgical resection by open heart surgery complete excision is the goal to avoid recurrence which occurs in 3% cases. Long term follow up & family screening for these tumors is highly recommended. Simple good Echo Cardiography can pick up these cases.
It has been rewarding surgery for these patients. Importance of early diagnosis & quick referral is key to successful surgical treatment .