Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia

Yury Shevchenko; Gleb Borshchev

doi:doi:10.11648/j.ijcts.20200606.13

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Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia

Yury Shevchenko, Gleb Borshchev

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 6, Issue 6)

Received: 20 November 2020 Accepted: 2 December 2020 Published: 16 December 2020

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Abstract

Myxoma of the right atrium is a rare heart tumor. Atrial myxomas are associated with a triad of complications, including obstruction, emboli, and constitutional symptoms (such as fever, weight loss). An interdisciplinary approach is very important to optimize the outcome in patients with atrial myxomas. When myxoma present, it can rarely cause blood flow obstruction in the right cardiac chamber. 75% to 80% are located on the left side of the interatrial septum. Right-sided cardiac myxomas present surgeons a lot of technical difficult. We report a case of right atrial myxoma. A 75-year-old female with a large right atrial myxoma underwent surgical treatment in our Center. Due to the high risk of embolic complications associated with conventional connection of a cardiopulmonary bypass machine, we decided to preform beating-heart surgery with clamping of major vessels (aorta, pulmonary artery, and venae cavae). This technique is a method of avoiding embolization. The early postoperative period was uneventful. Two days postoperatively, the patient was transferred from the intensive care unit to hospital ward. Nine days postoperatively, she was discharged in satisfactory condition to continue her follow-up at a local outpatient department. The patient was followed up during the next 3 years and had no signs of relapse.

Published in	International Journal of Cardiovascular and Thoracic Surgery (Volume 6, Issue 6)
DOI	10.11648/j.ijcts.20200606.13
Page(s)	75-78
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Heart Neoplasms/Surgery, Myxoma, Cardiac, Myxoma, Surgery, Off-pump

References

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[3]	Imperio, J, Summers D, Krasnow N, Piccone VA Jr. The distribution patterns of biatrial myxomas. Ann Thorac Surg 1980; 29: 469–73.
[4]	Hoffmeier A, Sindermann JR, Scheld HH, Martens S. Cardiac tumors-diagnosis and surgical treatment. Dtsch Arztebl Int. 2014; 111 (12): 205–211. doi: 10.3238/arztebl.2014.0205.
[5]	Fyke FE 3rd. Transesophageal echocardiography and cardiac masses. Mayo Clin Proc. 1991 Nov; 66 (11): 1171-4. PubMed PMID: 1943251.
[6]	Pinede L, Duhaut P, Loire R. Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases. Medicine. 2001; 80: 159–172.
[7]	Oliveira R, Branco L, Galrinho A, et al. Cardiac myxoma: a 13-year experience in echocardiographic diagnosis. Rev Port Cardiol. 2010; 29: 1087–1100.
[8]	McCarthy PM, Piehler JM, Schaff HV, Pluth JR, Orszulak TA, Vidaillet HJ Jr, Carney JA. The significance of multiple, recurrent, and "complex" cardiac myxomas. J Thorac Cardiovasc Surg. 1986 Mar; 91 (3): 389-96. PMID: 3951243.
[9]	Latifi AN, Ibe U, Gnanaraj J. A case report of atrial myxoma presenting with systemic embolization and myocardial infarction. Eur Heart J Case Rep. 2019 Jul 11; 3 (3): ytz104. doi: 10.1093/ehjcr/ytz104. PMID: 31660480; PMCID: PMC6764541.
[10]	Matsuoka S, Ito M, Shinonome T, Yoshitoshi M, Tanimura A. [An autopsy case of cerebral embolism caused by atrial myxoma]. No Shinkei Geka. 1992 Mar; 20 (3): 255-9. Japanese. PMID: 1557175.
[11]	Michiel P. van der Zee, Bart M. Koene, Massimo A. Mariani, Fatal air embolism during cardiopulmonary bypass: analysis of an incident and prevention measures, Interactive Cardio Vascular and Thoracic Surgery, Volume 19, Issue 5, November 2014, Pages 875–877, https://doi.org/10.1093/icvts/ivu242.
[12]	Neema PK, Pathak S, Varma PK, Manikandan S, Rathod RC, Tempe DK, Tung A. Case 2--2007: Systemic air embolization after termination of cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2007 Apr; 21 (2): 288-97. doi: 10.1053/j.jvca.2006.09.012. Epub 2007 Jan 9. PMID: 17418752.
[13]	DeFoe GR, Dame NA, Farrell MS, Ross CS, Langner CW, Likosky DS. Embolic activity during in vivo cardiopulmonary bypass. J Extra Corpor Technol. 2014; 46 (2): 150-156.
[14]	Taylor RL, Borger MA, Weisel RD, Fedorko L, Feindel CM. Cerebral microemboli during cardiopulmonary bypass: Increased emboli during perfusionist interventions. Ann Thorac Surg. 1999; 68: 89–93.
[15]	Blauth CI. Macroemboli and microemboli during cardiopulmonary bypass. Ann Thorac Surg. 1995 May; 59 (5): 1300-3. doi: 10.1016/0003-4975(95)00105-t. PMID: 7733756.

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APA Style

Yury Shevchenko, Gleb Borshchev. (2020). Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia. International Journal of Cardiovascular and Thoracic Surgery, 6(6), 75-78. https://doi.org/10.11648/j.ijcts.20200606.13

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ACS Style

Yury Shevchenko; Gleb Borshchev. Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia. Int. J. Cardiovasc. Thorac. Surg. 2020, 6(6), 75-78. doi: 10.11648/j.ijcts.20200606.13

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AMA Style

Yury Shevchenko, Gleb Borshchev. Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia. Int J Cardiovasc Thorac Surg. 2020;6(6):75-78. doi: 10.11648/j.ijcts.20200606.13

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@article{10.11648/j.ijcts.20200606.13,
  author = {Yury Shevchenko and Gleb Borshchev},
  title = {Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {6},
  number = {6},
  pages = {75-78},
  doi = {10.11648/j.ijcts.20200606.13},
  url = {https://doi.org/10.11648/j.ijcts.20200606.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20200606.13},
  abstract = {Myxoma of the right atrium is a rare heart tumor. Atrial myxomas are associated with a triad of complications, including obstruction, emboli, and constitutional symptoms (such as fever, weight loss). An interdisciplinary approach is very important to optimize the outcome in patients with atrial myxomas. When myxoma present, it can rarely cause blood flow obstruction in the right cardiac chamber. 75% to 80% are located on the left side of the interatrial septum. Right-sided cardiac myxomas present surgeons a lot of technical difficult. We report a case of right atrial myxoma. A 75-year-old female with a large right atrial myxoma underwent surgical treatment in our Center. Due to the high risk of embolic complications associated with conventional connection of a cardiopulmonary bypass machine, we decided to preform beating-heart surgery with clamping of major vessels (aorta, pulmonary artery, and venae cavae). This technique is a method of avoiding embolization. The early postoperative period was uneventful. Two days postoperatively, the patient was transferred from the intensive care unit to hospital ward. Nine days postoperatively, she was discharged in satisfactory condition to continue her follow-up at a local outpatient department. The patient was followed up during the next 3 years and had no signs of relapse.},
 year = {2020}
}

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TY - JOUR
T1 - Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia
AU - Yury Shevchenko
AU - Gleb Borshchev
Y1 - 2020/12/16
PY - 2020
N1 - https://doi.org/10.11648/j.ijcts.20200606.13
DO - 10.11648/j.ijcts.20200606.13
T2 - International Journal of Cardiovascular and Thoracic Surgery
JF - International Journal of Cardiovascular and Thoracic Surgery
JO - International Journal of Cardiovascular and Thoracic Surgery
SP - 75
EP - 78
PB - Science Publishing Group
SN - 2575-4882
UR - https://doi.org/10.11648/j.ijcts.20200606.13
AB - Myxoma of the right atrium is a rare heart tumor. Atrial myxomas are associated with a triad of complications, including obstruction, emboli, and constitutional symptoms (such as fever, weight loss). An interdisciplinary approach is very important to optimize the outcome in patients with atrial myxomas. When myxoma present, it can rarely cause blood flow obstruction in the right cardiac chamber. 75% to 80% are located on the left side of the interatrial septum. Right-sided cardiac myxomas present surgeons a lot of technical difficult. We report a case of right atrial myxoma. A 75-year-old female with a large right atrial myxoma underwent surgical treatment in our Center. Due to the high risk of embolic complications associated with conventional connection of a cardiopulmonary bypass machine, we decided to preform beating-heart surgery with clamping of major vessels (aorta, pulmonary artery, and venae cavae). This technique is a method of avoiding embolization. The early postoperative period was uneventful. Two days postoperatively, the patient was transferred from the intensive care unit to hospital ward. Nine days postoperatively, she was discharged in satisfactory condition to continue her follow-up at a local outpatient department. The patient was followed up during the next 3 years and had no signs of relapse.
VL - 6
IS - 6
ER -

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Author Information

Yury Shevchenko

Federal State Budgetary Institution “National Medical and Surgical Center Named After N. I. Pirogov” of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
Gleb Borshchev

Federal State Budgetary Institution “National Medical and Surgical Center Named After N. I. Pirogov” of the Ministry of Healthcare of the Russian Federation, Moscow, Russia

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APA Style

Yury Shevchenko, Gleb Borshchev. (2020). Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia. International Journal of Cardiovascular and Thoracic Surgery, 6(6), 75-78. https://doi.org/10.11648/j.ijcts.20200606.13

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ACS Style

Yury Shevchenko; Gleb Borshchev. Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia. Int. J. Cardiovasc. Thorac. Surg. 2020, 6(6), 75-78. doi: 10.11648/j.ijcts.20200606.13

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AMA Style

Yury Shevchenko, Gleb Borshchev. Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia. Int J Cardiovasc Thorac Surg. 2020;6(6):75-78. doi: 10.11648/j.ijcts.20200606.13

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@article{10.11648/j.ijcts.20200606.13,
  author = {Yury Shevchenko and Gleb Borshchev},
  title = {Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {6},
  number = {6},
  pages = {75-78},
  doi = {10.11648/j.ijcts.20200606.13},
  url = {https://doi.org/10.11648/j.ijcts.20200606.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20200606.13},
  abstract = {Myxoma of the right atrium is a rare heart tumor. Atrial myxomas are associated with a triad of complications, including obstruction, emboli, and constitutional symptoms (such as fever, weight loss). An interdisciplinary approach is very important to optimize the outcome in patients with atrial myxomas. When myxoma present, it can rarely cause blood flow obstruction in the right cardiac chamber. 75% to 80% are located on the left side of the interatrial septum. Right-sided cardiac myxomas present surgeons a lot of technical difficult. We report a case of right atrial myxoma. A 75-year-old female with a large right atrial myxoma underwent surgical treatment in our Center. Due to the high risk of embolic complications associated with conventional connection of a cardiopulmonary bypass machine, we decided to preform beating-heart surgery with clamping of major vessels (aorta, pulmonary artery, and venae cavae). This technique is a method of avoiding embolization. The early postoperative period was uneventful. Two days postoperatively, the patient was transferred from the intensive care unit to hospital ward. Nine days postoperatively, she was discharged in satisfactory condition to continue her follow-up at a local outpatient department. The patient was followed up during the next 3 years and had no signs of relapse.},
 year = {2020}
}

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