Name
ATRIAL MYXOMA
DESCRIPTION
DETAIL
MOST COMMON PRIMARY HEART TUMORS. 10% FAMILIAL, AUTOSOMAL DOMINANT* 2 - DIMENTIONAL ECHOCARDIOGRAPHY IS THE DIAGNOSTIC PROCEDURE OF CHOICE
TYPENOTES
10% ARE FAMILIALMedical Care: " Generally, evaluation can be performed on an outpatient basis. " A patient with embolic stroke requires hospitalization. " No known medical treatment exists for atrial myxoma. " Drug therapy is used only for complications such as congestive heart failure or cardiac arrhythmias. Surgical Care: " Operative resection of the myxoma is the treatment of choice. " The surgery is safe, with an early postoperative mortality of 2.2%. Some authorities believe resection should be performed immediately after the diagnosis is made. " Because of the risk of tumor fragmentation and embolization, vigorous palpation or manipulation should be performed only after cardioplegia. " Surgery for sporadic atrial myxoma is usually curative. Long-term prognosis is excellent. In a series of 112 patients, only 4 deaths occurred over a median follow-up of 3 years. o The recurrence rate is 1-5%. Recurrence after 4 years is uncommon. o The recurrence rate of familial patients is 20%. " Recurrence is usually attributed to incomplete excision of the tumor, growth from a second focus, or intracardiac implantation from the primary tumor. " Wider resection of the stalk attachment to the endocardium may reduce the burden of pretumorous cells. " A cloth patch or parietal pericardium is used to close the surgical defect. " Pretumorous cells around the stalk should be destroyed by laser photocoagulation. This obviates the need for a wide surgical resection. " To fully visualize both sides of the heart, some surgeons recommend a biatrial approach. " Damaged valves may require annuloplasty or prosthetic replacement. " Biannual echocardiograms are useful for early detection of recurrent tumors. Consultations: Cardiologists or cardiothoracic surgeons may be consulted. Diet: No special diet is required. Activity: Patients may engage in activities as tolerated. Follow up : Complications: " Congestive heart failure " Sudden death " Cardiac arrhythmias " Infection " Embolization
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
COMPLETE BLOOD COUNT, ECHOCARDIOGRAPHY, ECG