Resection of an obstructive neonatal cardiac myxoma of the infundibulum

Neonatal Myxomas: Case Report and Literature Review

Myxomas are rare tumors in neonates and tend to have a different presentation compared to adults. We present an infant with a left atrial myxoma presenting with episodic tachycardia who underwent successful surgical excision. In addition, we performed a review of the literature, identifying 17 cases of neonatal myxomas. Unlike adults, neonatal myxomas are more common in males and occur more often on the right side of the heart. Constitutional symptoms such as fever or embolism are rare among neonates. Most patients have favorable outcomes following surgical excision, refuting earlier claims that neonatal myxomas are associated with poor outcomes.

[Surgical results and monitoring of postoperative atrial myxomas]

OBJECTIVE

To analyze the casuistics of left atrial myxoma with emphasis on results and follow-up.

METHOD

We reviewed the clinical records of patients operated in the Hospital Cardiac Myxomas South Central High Specialty (HCSAE) of PEMEX in the last 7 years, with an emphasis on results and follow-up.

RESULTS

The analysis showed 10 patients, of whom 60% were female and 40% male, with ages from 12 to 76 years, with a mean age of 50 years. In the clinical characteristics of patients predominated dyspnea in 90%, followed by fatigue (80%) and chest pain (60%). The incidence was 90% for the left atrium and 10% for the right atrium, had tumors less than 3cm to up to over 10cm (average of 6 to 7cm). The pathology report was myxoma in the 100% of cases, the morbidity and early mortality was 0%, with a mean hospital stay of 6 days, and a patient of 12 years of age recurred and underwent surgery five months later. The 5-year survival was 100%.

CONCLUSIONS

The incidence of myxomas is well known for rare presentation, the experience in this national medical center is one patient for every 350 operations, one case per year with no mortality and excellent survival.

Neonatal aortic arch obstruction due to pedunculated left ventricular foetal myxoma

Myxoma in neonatal life are extremely rare. We report a case of a neonate with a pedunculated cardiac tumour arising from the anterolateral left ventricular wall protruding across the left ventricular outflow tract and continuously extending into the distal aortic arch. Surgical removal at 14 days of age via combined transaortic approach and apical ventriculotomy was indicated because of the risk of further compromise of aortic valve function and aortic arch obstruction. Histopathologic examination was consistent with a myxoma.

Cardiac myxoma with prenatal diagnosis

The presentation of myxoma in the neonatal period is quite rare. We report the case of a female patient in whom two cardiac tumors were diagnosed prenatally. Surgery was performed at eight days of age, using cardiopulmonary bypass and circulatory arrest to facilitate excision of two polypoid tumors from within the right atrium. Pathology studies were consistent with myxoma. The postoperative course was satisfactory and the patient was discharged 14 days after surgery, at 22 days old.

Investigation of a myxoma in the right ventricular outflow tract

We describe an atypical myxoma in the right ventricular outflow tract of a 12-year old girl. After identification using echocardiography, we assessed its precise location and attachments by magnetic resonance imaging. Subsequent to surgical removal, histology confirmed the myxomatous nature of the tumour.