Introduction: Cardiac myxomas are the most frequent cardiac tumors. The aim of study is to describe the incidence, clinical symptoms, investigation findings and surgical management of cardiac myxomas.

Methods: From July 2015 to July 2017, 15 patients of primary intracardiac myxoma underwent surgical excision at our institute. Their age ranged from 40 years to 65 years with predominance of female patients (73.3%). Surgical resection was done in all the cases via biatrial approach or right atriotomy. Post-operative echocardiogram was done in all patients before discharge. Maximal follow-up of two years and minimum follow-up of 6 months was done after surgery.

Results: The tumors presented in a variety of ways, namely, dyspnea (66.7%), chest pain (26.27%) and transient ischemic attack (6.6%), beingthe common modes of presentation. The most common location for the tumor was the left atrium (80%) with the fossa ovalis being the most common (66.7%) site of attachment. No mortality or any significant morbidity was found. On follow-up all patients were in NYHA class 1 and their echocardiography showed good ventricular function with normal pulmonary artery pressure with patch in situ. No recurrence was reported till date.

Conclusion: Early diagnosis and surgical resection of cardiac myxomas contributes to excellent prognosis and associated with low complications and recurrences rate. Regular long-term follow-up should be done in all patients with cardiac myxomas.

Keywords: Cardiac myxomas, rightatriotomy, echocardiography.

1. Di Vito A, Mignogna C, Donato G. The mysterious pathways of cardiac myxomas: a review of histogenesis, pathogenesis and pathology. Histopathology 2015; 66: 321–332.
2. Garatti A, Nano G, Canziani A, Gagliardotto P, Mossuto E, Frigiola A, et al. Surgical excision of cardiac myxomas: Twenty years experience at a single institution. Ann ThoracSurg 2012;93:825-31.
3. Yu K, Liu Y, Wang H, Hu S, Long C. Epidemiological and pathological characteristics of cardiac tumors: A clinical study of 242 cases. Interact Cardiovasc ThoracSurg 2007;6:636-9.
4. Strecker T, Agaimy A, Zelzer P, Weyand M, Wachter DL. Incidental finding of a giant asymptomatic right atrial tumor.Int J Clin Exp Pathol 2014; 7:4528–4530.
5. Reynen K. Cardiac myxomas. N Engl J Med 1995; 333:1610–1617
6. Bjessmo S, Ivert T. Cardiac myxoma: 40 years’ experience in 63 patients. Ann Thorac Surg. 1997;63:697–700.
7. Dein JR, Frist WH, Stinson EB, et al. Primary cardiac neoplasms. Early and late results of surgical treatment in 42 patients. J Thorac Cardiovasc Surg 1987;93(04):502–511
8. Ha JW, Kang WC, Chung N, et al. Echocardiographic and morphologic characteristics of left atrial myxoma and their relation to systemic embolism. Am J Cardiol 1999;83:1579-82.
9. Premaratne S, Hasaniya NW, Arakaki HY, Mugiishi MM, Mamiya RT, McNamara JJ. Atrial myxomas: experiences with 35 patients in Hawaii. Am J Surg 1995;169:600-3.
10. Pinede L, Duhaut P, Loire R. Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases. Medicine (Baltimore) 2001;80:159-72.
11. El Bardissi AW, Dearani JA, Daly RC, et al. Analysis of benign ventricular tumors: long-term outcome after resection. J Thorac Cardiovasc Surg 2008;135:1061-8.
12. Pacini D, Careddu L, Pantaleo A, et al. Primary benign cardiac tumours: long-term results. Eur J Cardiothorac Surg 2012;41:812-9.
13. Craford C. Discussion of Glover R. The technique of mitral commisurotomy. In: Lam CR, editor. Cardiovascular surgery: studies in physiology, diagnosis and techniques. International Symposium on Cardiovascular Surgery; 1955 Mar; Henry Ford Hospital, Detroit. Philadelphia: Saunders; 1955 Mar.
14. Kuroczyński W, Peivandi AA, Ewald P, Pruefer D, Heinemann M, Vahl CF. Cardiac myxomas: short- and long-term follow-up. Cardiol J 2009;16:447-54.
15. McCarthy PM, Piehler JM, Schaff HV, Pluth JR, Orszulak TA, Vidaillet HJ Jr, et al. The significance of multiple, recurrent and “complex” cardiac myxomas. J ThoracCardiovascSurg 1986;91:389-96.

Dr. Dhananjay Bansal (MCh CTVS)

Dept. of CTVS, ABVIMS, Dr. RML Hospital, New Delhi, India