Recurrent Cardiac Myxoma Treated by Orthotopic Heart Transplantation: A Case Report and Literature Review of Heart Transplantation for Primary Cardiac Tumor
Table 2
Tumor characteristic and operations detail.
No. of surgery (year)
Location and size
Surgical Method
Non-resectable mass
Complication
Residual mass
Pathology
1st surgery (2008)
Echocardiography: Endocardial cardiac mass (3.5x4.8 cm) protruded from LA septum and MV anterior leaflet to LA cavity Intra-op: 5x6x6 cm mass attached to the septum of the LA with no involvement of MV
Open midline-sternotomy for tumor removal
NA
None
Echocardiography (4 days after operation): Tumor remnant (4mm) and mild MV regurgitation.
Myxoma at LA mass. Margin: N/A
2nd surgery (2010)
Echocardiography: LA mass (2.5x1.9cm) obstructing MV inflow. LV mass (1.78x0.97cm) was detected at LV free wall near apex Intra-operation: A 4-cm LA mass attached to LA wall, a 1-cm mass attached to wall of right superior PV, a 0.5-cm mass attached to interatrial septum and 1-cm and 2-cm LV masses
Open midline-sternotomy for tumor removal
None
None
Echocardiography (1 week after the operation): No tumor residual.
Myxoma at LA, right superior PV, lower interatrial septum, LV masses. Clear margin.
3rd surgery (2012)
Echocardiography: RV mass (2.8x4.7cm) from RV apex extended to RV outflow tract. Intra-operation: 5-cm mass at axillary surface and multiple small mass at RV endocardium
Open midline-sternotomy for tumor removal
None
Suspected embolic stroke 1 day after the operation. Patient improved without any intervention
Echocardiography (1 week after the operation): No tumor residual.
Myxoma at RV mass Clear margin.
RA: right atrium, LA: left atrium, RV: right ventricle, LV: left ventricle, PA: pulmonary artery, PV: pulmonary vein, MV: mitral valve, and intra-op: intra-operation.