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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Frequency: Bi-Monthly

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1999 February;40(1):101-5

CARDIAC PAPERS 

    ORIGINAL ARTICLES

Sur­gical man­age­ment of ­right ­atrial myx­omas. A 15 ­year expe­ri­ence ­with ­review of the lit­er­a­ture

Selvaraj A., Kumar R., Ravikumar E.

From the Depart­ment of Car­di­oth­o­racic Sur­gery Chris­tian Med­ical Col­lege & Hos­pital, Vel­lore, ­South ­India

Back­ground. A ret­ro­spec­tive ­study to eval­uate the clin­ical symp­toms, ­signs, inves­ti­ga­tions, sur­gical tech­nique and ­follow-up of an ­uncommon car­diac ­tumour.
­Methods. Experi­mental ­design and set­ting: ­this ret­ro­spec­tive ­study was car­ried out in a ter­tiary ­care hos­pital in ­South ­India on ­patients ­treated ­from 1981 to 1996.
Dura­tion of ­follow-up has ­been for a max­imum ­period of 9.5 ­years. Par­tic­i­pants: all ­patients who ­were diag­nosed to ­have ­right ­atrial ­myxoma ­were ­included in ­this ­study. ­There ­were ­seven ­patients (4 ­males, 3 ­females) ­with ­ages ­ranging ­from 16 to 52 ­years. Inter­ven­tions: six of ­these ­patients under­went com­plete exci­sion. One ­patient who pre­sented ­with SVC obstruc­tion had ­locally inva­sive ­tumour and ­only a ­biopsy was ­done. In ­order to ­reduce the ­risk of intra­op­er­a­tive pul­mo­nary embo­lism in the ­last two ­cases, we cross­clamped the pul­mo­nary ­artery as ­soon as car­di­o­pul­mo­nary ­bypass was ­initiated.
­Results. ­There was one post­op­er­a­tive ­death due to refrac­tory ­right ven­tric­ular ­failure (14.3%). ­Four ­patients ­have ­been fol­lowed-up for a ­mean of 40.7 ­months. All of ­them are ­free of recur­rence and ­most of ­them are asymp­to­matic.
Con­clu­sions. ­Right ­atrial ­myxoma is a ­rare usu­ally ­benign car­diac ­tumor ­whose defin­i­tive diag­nosis is ­made on the ­basis of 2D ech­o­car­di­og­raphy. The cru­cial ­aspects of sur­gery are meas­ures for pre­ven­tion of intra­op­er­a­tive embo­lism, en-­bloc exci­sion of the ­tumour ­with a ­wide ­cuff of ­normal ­tissue and inspec­tion of all ­four cham­bers in ­order to ­avoid ­missing ­tumour ­emboli or an occa­sional mul­ti­cen­tric ­lesion. ­Patients ­with myx­om­a­tous ­emboli ­into the pul­mo­nary ­artery ­require simul­ta­neous pul­mo­nary embo­lec­tomy.

language: English


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