Cardiac Tumors/myxoma Surgery

Cardiac Tumor and Myxoma Surgery in India: Advanced Heart Care

Cardiac tumors, including myxomas, are rare growths that develop in the heart and can disrupt normal heart function.

Myxomas, the most common type of benign heart tumor, are usually found in the left atrium and may cause symptoms such as shortness of breath, chest pain, or irregular heartbeat. If left untreated, they can lead to serious complications such as embolism or heart failure.

In India, cardiac tumor and myxoma surgery is performed by highly skilled cardiac surgeons using advanced surgical techniques and state-of-the-art facilities.

The procedure typically involves the complete removal of the tumor through minimally invasive or open-heart surgery, depending on the size and location of the tumor.

India is known for providing world-class cardiac care at affordable costs, making it a preferred destination for patients seeking effective treatment.

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Atrial myxomas are the most common primary heart tumors. Because of nonspecific symptoms, early diagnosis may be a challenge. Left atrial myxoma may or may not produce characteristic findings on auscultation. Two-dimensional echocardiography is the diagnostic procedure of choice. Most atrial myxomas are benign and can be removed by surgical resection.

Pathophysiology in India

Myxomas account for 40-50% of primary cardiac tumors. Approximately 90% are solitary and pedunculated, and 75-85% occur in the left atrial cavity. Up to 25% of cases are found in the right atrium. Most cases are sporadic. Approximately 10% are familial and are transmitted in an autosomal dominant mode. Multiple tumors occur in approximately 50% of familial cases and are more frequently located in the ventricle (13% vs 2% in sporadic cases).

Myxomas are polypoid, round, or oval. They are gelatinous with a smooth or lobulated surface and usually are white, yellowish, or brown. The most common site of attachment is at the border of the fossa ovalis in the left atrium, although myxomas can also originate from the posterior atrial wall, the anterior atrial wall, or the atrial appendage. The mobility of the tumor depends upon the extent of attachment to the interatrial septum and the length of the stalk.

Although atrial myxomas are typically benign, local recurrence due to inadequate resection or malignant change has been reported. Occasionally, atrial myxomas recur at a distant site because of intravascular tumor embolization. The risk of recurrence is higher in the familial myxoma syndrome.1

Symptoms are produced by mechanical interference with cardiac function or embolization. Being intravascular and friable, myxomas account for most cases of tumor embolism. Embolism occurs in about 30-40% of patients. The site of embolism is dependent upon the location (left or right atrium) and the presence of an intracardiac shunt.

Jong-Won Ha and associates reported a more frequent occurrence of systemic embolism in polypoid tumors as compared to round (58% vs 0%).2 Also, polypoid tumors more frequently prolapse into the ventricle. Prolapse of a tumor through the mitral or tricuspid valve may result in the destruction of the annulus or valve leaflets. In one study, 19% of the patients had atrial fibrillation associated with large atrial myxoma. Left atrial myxomas produce symptoms when they reach about 70 g. Right atrial myxomas grow to approximately twice this size before becoming symptomatic. Tumors vary widely in size, ranging from 1-15 cm in diameter. Rate of growth is not exactly known. In one case report, right atrial myxoma had a growth rate of 1.36 x 0.03 cm/month.

Symptoms in India

Symptoms may occur at any time, but most often they accompany a change of body position. Symptoms may include : –

Shortness of breath with activity
Breathing difficulty when lying flat
Breathing difficulty when asleep
Dizziness
Fainting
Sensation of feeling your heart beat (palpitations)
Chest pain or tightness

The symptoms and signs of left atrial myxomas often mimic mitral stenosis. General symptoms may also be present, such as : –

Cough
Fever
Involuntary weight loss
General discomfort (malaise)
Joint pain
Blueness of skin, especially the fingers (Raynaud’s phenomenon)
Fingers that change color upon pressure or with cold or stress
Curvature of nails accompanied with soft tissue enlargement (clubbing) of the fingers
Swelling – any part of the body

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