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Operative management and outcomes in patients with myxomas: A single-center experience
Ahmed Abdulfattah Alhasso1, Okba F Ahmed2, Dana H Mohammed-Saeed3,4,5
1Department of Cardiac Surgery, Ibn Albittar Cardiac Surgeon, Baghdad, Iraq.
Insights
This study reviews 80 cardiac myxoma cases, finding the left atrium most affected. Complete tumor resection via median sternotomy is key to reducing recurrence and mortality risks.
Area of Science:
- Cardiology
- Cardiac Surgery
- Oncology
Background:
- Cardiac myxoma is a rare tumor with potential for serious complications like heart failure and sudden death.
- Management of cardiac myxoma requires careful surgical consideration due to risks of embolization and obstruction.
Purpose of the Study:
- To report an 11-year single-center experience in managing cardiac myxoma.
- To analyze the outcomes of surgical interventions for cardiac myxoma.
Main Methods:
- Retrospective case series of 80 cardiac myxoma patients.
- Preoperative diagnosis using transthoracic echocardiography.
- Surgical resection via median sternotomy with thorough exploration of all cardiac chambers.
Main Results:
- Predominantly affected females (67.5%) with a mean age of 46.3 years.
- Left atrium was the most common site (83.75%); shortness of breath was the most frequent symptom (86.25%).
- Reported an 11.25% recurrence rate and a 3.75% mortality rate.
Conclusions:
- Complete tumor resection is the primary goal for successful myxoma management.
- Transthoracic echocardiography and standard median sternotomy contribute to decreased recurrence, embolism, and mortality rates.
- Careful surgical planning and execution are crucial for mitigating risks associated with cardiac myxoma intervention.
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.
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