Ventricular Myxoma Research Articles

Possibile mixoma endoventricolare sinistro in paziente con TVP degli arti inferiori: considerazioni da un caso clinico

Summary Introduction We describe an unusual case of left ventricular myxoma associated with deep vein thrombosis (DVT). Materials and methods A 79-year-old woman was admitted with bilateral proximal DVT that developed while she was on warfarin. The anticoagulant therapy had been started (after 2 weeks of low-molecular weight heparin) 1 month earlier in a Cardiologic Unit, where the patient had been treated for “left ventricular thrombosis associated with acute pericarditis”. After discharge, the patient continued to experience malaise, recurrent dizziness, dyspnea, flushing, and progressively severe leg swelling despite transthoracic echocardiography (TTE) findings of normal left ventricular function. She was finally admitted to our Unit for ultrasound studies for possible DVT. On admission the INR was in the therapeutic range with increased C-reactive protein (CRP), thrombocytopenia, mild anemia, anti-PF4 antibodies, lupus anticoagulant (LAC), a positive direct Coombs test, and mildly increased anti-platelet and anticardiolipin antibody levels. Malignancy, SLE, and inherited thrombophilia were excluded by a broad-spectrum instrumental and laboratory investigation. Since heparin-induced-thrombocytopenia could not be excluded, the warfarin was replaced with fondaparinux (7.5 mg/day). Given the persistence on TTE of a “small floating mass” at the left ventricular apex, we suspected the previously diagnosed thrombosis was actually an unusually located myxoma, and this diagnosis was confirmed by CT and MRI. The patient also had markedly increased serum levels of interleukin 6 (IL-6), regarded by many as a marker of cardiac myxoma and the source of the constitutional symptoms and immunologic features (“activity”) of these lesions. The patient is now well except for recurrent flushing episodes. The IL-6 level is still high although the ESR, CRP, LAC have normalized. Since isolated IL-6 increases are associated with recurrence in PMR patients, we consider our patient at risk for relapse of systemic illness. Results Three cases of cardiac myxoma associated with DVT have been reported. Myxoma production of IL-6 could explain the extracardiac symptoms and the inflammatory/autoimmune activation that caused the DVT. Discussion Although histologic confirmation is lacking, the features of this case strongly suggest an atypical-site myxoma, in particular the concordant findings generated by the various diagnostic exams and unchanging nature of the ventricular lesion during follow-up.

Excision of left atrial and right ventricular myxoma through biatrial approach: correction please!

Excision of left atrial and right ventricular myxoma through biatrial approach: correction please!

Recurrence of a Familial Giant Multilocular Cardiac Myxoma in a Patient With Carney's Complex

A 20-year-old woman, whose father had a past medical history of Carney complex (cardiac myxoma and spotty pigmentation of the skin), was referred to our hospital with a necrotic fingertip. Vital signs and physical examination revealed no additional pathological findings. Blood count showed a slight anemia with a hemoglobin of 11.5 g/dL (reference range 12 to 18 g/dL), and the serum level of C-reactive protein was 57 mg/L (reference range 0 to 5 mg/L). 2D and 3D echocardiography revealed a giant left-ventricular tumor originating from the posterior papillary muscle and posterior wall, prolapsing into the left ventricular outflow tract during systole. A second tumor in the left atrium originating from the mitral valve with diastolic prolapse into the left ventricle could be diagnosed (Figure 1, see also Movies 1–3). The patient underwent immediate surgery. As a result of infiltrating tumor growth, a part of the papillary muscle and some chordae had to be resected. The mitral valve was reconstructed using artificial chordae and ring annuloplasty. Histological findings confirmed a diagnosis of cardiac myxoma (Figure 2). In a 1-year follow-up, the patient was free of symptoms, and echocardiography did not show any signs of …

Stroke Caused by Left Ventricular Myxoma

![Figure][1] ![Figure][1] [![Graphic][3] ][3] Transthoracic Echocardiography, Long-Axis Parasternal View A large mass is seen in the left ventricle with grapelike clusters measuring 53 × 34 × 29 mm, almost protruding through the aortic valve in systole. ![Figure][1]</img

Left atrial and right ventricular myxoma: an uncommon presentation of a rare tumour

Myxomas are rare tumours but are the most common benign tumours of the heart. They can arise from any heart chamber. However, they arise more frequently from the left atrium. They have rarely been described as originating from two different chambers. Their clinical presentation is varied and may mimic arterial embolism or symptoms of cardiac, infectious, malignant and immune diseases, therefore making their diagnosis challenging. We report a case of a young female patient with left atrial and right ventricular myxomas who initially presented with neurological symptoms (visual and speech disturbances). Transoesophageal echocardiography has become an invaluable tool to diagnose myxomas and plan the surgical approach.

Left ventricular myxoma in a child: a case report

Left ventricular myxoma are quite rare and have not been reported in children. We report a left ventricular myxoma arising from interventricular septum in a 12-year-old girl who presented with history of single episode of syncope while playing in school. General examination of the child did not reveal any abnormality except a grade II/VI systolic murmur in left parasternal area. Transthoracic echocardiography revealed a round pedunculated mass (18 × 30 mm) in left ventricle arising from middle of interventricular septum with a pedicle measuring 4 mm at its base. The tumour was projecting through aortic valve in systole. Syncope in this case was probably due to obstruction of left ventricular outflow tract by myxoma leading to a decrease in cardiac output. Complete excision of myxoma was done through transmitral approach.

Diagnosis and results of treatment of heart myxoma

Myxoma is the most common benign primary cardiac neoplasm, and usually originates from the left atrial septum. Early diagnosis of cardiac myxomas depends on a high index of a clinical suspicion. Surgical management must be done as soon as possible after diagnosis. The aim of this retrospective study was to present diagnostics and treatment outcome data of 61 patients with cardiac myxoma treated in the Military Medical Academy, Belgrade during a 49-years period. Intra-hospital diagnosis was established in all the patients by the cardiologist. Diagnostic methods were various, in dependence on the examination period and suspected diagnosis. Within a 49-years period (1961-2009) heart myxoma was diagnozed and treated in 61 patients in the Military Medical Academy, Belgrade. Most of the operated patients were females (38 or 62.3%). The operated patients were 19-68 years old. Average age of all the patients was 47.9%. The great majority of them (98.4%) had atrial, and only one operated patient had ventricular myxoma. In 13 (21.3%) of the patients heart myxoma was found out accidentally due to no previous cardiologic symptomatology. In most patients (27.44%) symptomatology was presented as thromboembolic disease. Because of the suspected ventricular myxoma in one patient, the patient was operated on, but Hodgkin's lymphoma was found out which, according to the subsequent course of the disease, could be justifiably recognized as primary heart lymphoma. This study presented brief descriptions of the course of the disease in 4 patients with myxomas in each of the cardiac cavities. The only diagnostic difficulty in cardiac myxoma is due to its asymptomatic and oligosymptomatic presence within the longer period of time, namely, its growth period. Echocardiography should be the standard method of cardiologic examination of these patients, which could considerably contribute to early diagnosis and treatment of heart myxoma. Surgical extirpation of myxoma is the only and very successful therapeutic method.

Intravenous Thrombolysis of Occlusion in the Middle Cerebral and Retinal Arteries from Presumed Ventricular Myxoma

Background. Although thrombolytic therapy has been shown to be beneficial to stroke patients, the effectiveness of intravenous thrombolysis in ischemic stroke patients with ventricle myxoma is unknown. Case Description. A 22-year-old woman with left hemiplegia was sent to the emergency department at a teaching hospital. The magnetic resonance angiography showed occlusion of the right middle cerebral artery, and the echocardiography showed a mass in the left ventricle. Intravenous recombined tissue plasminogen activator (rt-PA) was administrated, and the postthrombolysis transcranial Doppler exam showed that her right middle cerebral artery was circulative. The patient's condition improved gradually, and no complication was observed up to 16 months of follow-up. Conclusion. Intravenous rt-PA is a reasonable treatment for stroke patients with ventricle myxoma.

Left Atrial Myxoma Embolus to the Renal Artery: Should a Nephrectomy Be Advised?

Cardiac myxoma represents the most common primary cardiac tumor, which accounts for 75% of all benign cardiac tumors. Embolization is a well-known hazard of myxoma and can be a presenting feature. Resection is generally recommended for cardiac myxomata; once identified but less understood is what to do with systemic emboli. Although extremely uncommon, the literature contains a number of examples of metastatic myxomata with active growth at the site of embolic implantation, with most cases being cerebral. We present an unusual case of embolic occlusion of the right renal artery from a left ventricular myxoma. Excision of the tumor required cardiac autotransplantation and mitral valve replacement. Subsequent right nephrectomy revealed renal artery occlusion with pathologically viable myxoma tissue.

Left ventricular myxoma: Confusing intracardiac mass in a patient with leukemia in remission

Abstract Cardiac myxomas are the most common primary benign tumors of the heart and appears particularly in the left atrium. Myxomas exhibit a wide spectrum of symptoms from asymptomatic to very serious according to the localisation of the tumours. Only 5% of these tumours occur in the right and left ventricles. We report an unusual case of a 21-year-old woman with a leukemia in remission, in whom routine transthorasic echocardiographic examination demonstrated an incidental left ventricular mass. The patient underwent successful resection of the left ventricular mass under cardiopulmonary bypass through the left atrial approach. Histopathologic examination was diagnostic for myxoma. In this case, the presentation of the mass was atypical for two reasons: the tumour was a cardiac myxoma in the left ventricular localisation and in a patient with leukemia in remission.

Combination of Right Atrial and Left Ventricular Myxoma

Myxomas are common cardiac tumors that are managed by complete excision. The combination of a right atrial and left ventricular myxoma is very rare. We discuss a patient with right atrial and left ventricular myxoma who underwent successful surgical excision of both myxomas. There was no clinical or echocardiographic recurrence or valvular insufficiency at the 6-month follow-up.

Left Ventricular Myxoma Accompanied with Congenital Atrial Septal Defect

Left Ventricular Myxoma Accompanied with Congenital Atrial Septal Defect

Right Ventricular Myxoma Obstructing the Outflow Tract

Cardiac myxomas are benign tumors of endocardial origin. Symptoms might mimic heart disease as well as infectious disease, immunodeficiency, and malignant processes. We present the case of a 59-year-old female patient with a large right ventricular myxoma that was connected to the basal interventricular septum. Movement in systole provoked the obstruction of the right ventricular outflow tract. She presented clinically with syncope, systolic murmur, and signs of right heart failure. The diagnosis of the right ventricular tumor was based on 2D echocardiography, magnetic resonance, and multislice computed tomography findings.Emergency surgical excision of the myxoma was necessary to prevent embolism and sudden death.

Technique of excision of LV myxoma prolapsing into aorta

A life-threatening Left Ventricular (LV) outflow tract obstruction developed in a 29-year-old lady because of a very uncommon myxoma emerging from the left ventricular apex. Immediate surgical treatment was indicated because of high-risk factors reported herein. After transaortic resection of a single myxoma, the progress of this patient has been excellent We describe a technique of excision of a left ventricular myxoma prolapsing into the aorta. We successfully excised a 5.4 × 3.2 cm tumor prolapsing into the aorta via the transaortic approach under Femoro-bicaval bypass.

Right ventricle myxoma obstructing partially right ventricular outflow tract

A 13-year old female was referred from paediatric department for severe dyspnoea (stage III NYHA), with swelling of the face and the lower limbs. The physical examination revealed bad general health status and a clinical anaemia. There was also an enlargement of the jugular veins and the liver. The heart auscultation allowed a diagnosis of a pulmonary stenosis bruit, which was not varying with the changes of postures. The patient did not present any neuro-endocrine clinical signs or skin problems.The transthoracic echocardiography (TTE) revealed a cardiac tumour mimicking a myxoma was implanted on the antero lateral side of the right ventricular wall with an expansion into the outflow tract. The patient was operated within 48 hours following her admission. On CPB the tumour looking like myxoma was excised through a right atriotomy. The tricuspid valve was normal. Cross clamping time was 15 minutes. The pathological examination showed a myxoma-like tumour with two lobes measuring 4.2 x 2.3 centimeters. The evolution was simple; the post operative TTE check ups were satisfactoryRight ventricular myxoma protruding into the outflow tract is rare and can present with right heart failure. Surgical excision is seldom possible.We emphasize the importance of periodic follow up of this young patient with TEE for early detection of recurrence.

Ressecção de mixoma ventricular esquerdo após acidente vascular cerebral embólico

Cardiac myxoma is the most common primary tumor of the heart. The tumor is located mainly in the left atrium but can arise from any heart chamber. Clinical symptoms are variable but dyspnea and embolism are the most frequent. We report a case of a young man that had embolic ischemic stroke caused by a large left ventricular myxoma. The patient underwent surgery three weeks after the stroke. The tumor was carefully resected without fragmentation. Surgical treatment was effective. We emphasize the rarity of this location together with a review of the current literature.

Right ventricular myxoma obstructing the pulmonary artery during early childhood

Primary cardiac tumors are uncommon during infancy and childhood. Myxomas originating in the right ventricle are even less common in pediatric patients. A 2-year-old girl was referred to our hospital under a diagnosis of right ventricular tumor. The aim of the operation was extirpation of the tumor. Perioperative cardiac arrest occurred when the tumor obstructed the pulmonary artery. After promptly establishing cardiopulmonary bypass, the tumor was removed from the right ventricular outflow tract. The patient was discharged on the 13th postoperative day without complications.

Right Ventricular Myxoma Detected Incidentally in a Young Athlete

Right Ventricular Myxoma Detected Incidentally in a Young Athlete

Saccular True Aneurysm of the Ascending Aorta 19 Years After Aortic Cannulation: Report of a Case

A 61-year-old woman who had undergone surgery for a right ventricular myxoma 19 years earlier was admitted to our hospital for treatment of a saccular aneurysm of the ascending aorta at the site of the previous aortic cannulation. We resected the aneurysm completely and closed it with a polyester patch. Pathologic examination revealed an aortic wall saccular aneurysm, without atherosclerotic changes or bacterial cultures, consisting of elastic fibrous tissue and artificial material. There were inflammatory changes at the top of the aneurysm, with continuity of medial elastic fibrous tissue inside. These pathological findings strongly suggested a true aneurysm with continuity of medial elastic fibrous tissue. We report this extremely unusual case of a saccular true aneurysm at a previous aortic cannulation site.

Right Ventricular Myxoma Causing Right Ventricular Outflow Tract Obstruction

Cardiac myxomas are the most common neoplasms of the heart. They can be located in any chamber of the heart but frequently in the left atrium. In this report we present a patient who had been treated for a right ventricular myxoma originating from the interventricular septum and leading to right ventricular outflow tract obstruction.