Left Atrial Myxoma in Pregnancy: Management Strategy Using Minimally Invasive Surgical Approach

Management of left atrial myxoma in pregnant women: a case series

BACKGROUND

Left atrial myxoma during pregnancy is rare. We present three cases in order to aid in the management.

CASE PRESENTATION

Three cases of left atrial myxoma during pregnancy were presented in this article. Three patients all received multidisciplinary team work and acquired good outcomes. The case 1 had no symptoms and delivered before traditional cardiac surgery. The case 2 and case 3 undergone totally endoscopic minimally invasive cardiac surgery during pregnancy. The case 3 maintained pregnancy to term and gave birth to a healthy baby via vaginal delivery. No relapse of the tumor was observed.

CONCLUSIONS

The management of left atrial myxoma during pregnancy ought to be individualized and combined with the gestational age. If the diagnosis was made in the first two trimesters of pregnancy, totally endoscopic minimally invasive cardiac surgery during pregnancy would be an optimal choice. The patients can benefit from the multidisciplinary team work.

Case Report: Totally endoscopic minimally invasive mitral valve surgery during pregnancy: a case series

A totally endoscopic minimally invasive approach is widely used for cardiac valve surgery in normal adults. However, minimally invasive cardiac surgery during pregnancy is rarely reported. In addition to traditional median thoracotomy, totally endoscopic minimally invasive approaches can now be used for pregnant patients. We describe our experience with totally endoscopic cardiac valve surgery (TECVS) during pregnancy, which is safe for both mothers and fetuses.

Successful Management of Maternal Left Atrial Myxoma in Pregnancy

A 29-year-old woman (gravida 3, para 2) presented at 28 weeks+2 days of gestation with a two-months history of dyspnea associated with orthopnea and occasional palpitations. On transthoracic echocardiography, she was diagnosed with a 3.2 × 2.7 cm left atrial myxoma. The patient underwent open surgical resection at 30 weeks of gestation. She had an uneventful postoperative recovery and was discharged on the ninth day. At 41 weeks of gestation, she gave birth by cesarean to a healthy baby of normal weight. Both the mother and the baby were discharged in stable condition.

Operative management and outcomes in patients with myxomas: A single-center experience

Background

Cardiac myxoma is a rare cardiac tumor that may be asymptomatic or can cause embolization or intracardiac obstruction, leading to heart failure, sudden cardiac death, and arrhythmia. This study aims to report an 11-year experience of a single center in the management of cardiac myxoma.

Method

This study is a single-center retrospective case series. Eighty cases of cardiac myxoma were collected in Ibn Albitar's specialized center for cardiac surgery. Transthoracic echocardiography was used to make the preoperative diagnosis in all patients. The surgeries were undertaken through the standard approach of a median sternotomy. All four cardiac chambers were thoroughly explored for additional myxomas. The major objective of the operations was complete tumor resection.

Result

The mean age of the patients was 46.3 years. Females (67.5%) were predominant over males (32.5%). Shortness of breath was the most common symptom (86.25%). The left atrium was the most affected site (83.75%), followed by the right atrium (13.75%). Coronary artery bypass grafting was required as the secondary or associated intervention in 19 (23.75%) cases. The recurrence rate was 11.25%, with a mortality rate of 3.75%.

Conclusion

Recurrence and tumor embolism are risks of surgical intervention for myxoma. Good preparation using transthoracic echocardiography as a diagnostic tool and standard median sternotomy to complete resection of the tumors can decrease the rate of recurrence, embolism, and even mortality.

Clinical Case Report: Cardiac Myxoma in Pregnancy

BACKGROUND: This article describes cardiac myxoma in a pregnant woman at 15 weeks of gestation. CASE PRESENTATION: A large left atrial myxoma, despite the asymptomatic clinical presentation, was diagnosed during echocardiography. Given the significant risk of cardiac complications, the tumor was surgically removed at 19 weeks gestation. The postoperative period as well as the second and third trimesters of pregnancy were uneventful. At 40 weeks of gestation, live full-term baby was born by vaginal birth mode of delivery without any apparent pathology. CONCLUSION: This case demonstrates the significance of timely diagnosis and treatment of myxoma as well as the need for continuous monitoring at different stages of pregnancy and their positive impact on disease outcome.