ABSTRACT
Introduction: Cardiac tumors constitute only 0.2% of all tumors. Primary cardiac tumors occur infrequently with an incidence of 0.0017% to 0.19%, estimated on autopsies performed in non-selected populations. Left atrial myxomas are the most prevalent [75% to 80%] and right atrial are less common [10% to 18%]. Surgical excision yields an excellent prognosis and recurrence rate of only 3% with a very low morbidity and mortality
Objective: We aimed to review our experiences with this rare entity and highlight the various aspects of myxoma presentation, diagnosis and outcomes
Methodology: A retrospective chart review done on patients underwent excision of myxoma with histopathological confirmation since January 1991 till December 2015. Standard surgical approach adopted was single atrial, augmented with Biatrial approach where needed
Results: A total 42 cases were identified and 28 cases with complete data were included in the analysis. Mean age was 54.4 [ +/- 17.7] years, with female predominance [58% vs. 42%]. Preoperative comorbidities included hypertension [39.2%], diabetes [28.5%], IHD, dyslipidemia, and COPD [10.7%] that were comparable among gender. The mean dimension of myxoma measured on echocardiography was 4.9x3.5x2.7 cm. Sixty four percent had left sided and 35.7% had right sided myxoma. Most common symptom was dyspnea [71%], constitutional symptoms [39.3%] and stroke in [18%]. Echo being the diagnostic modality of choice. Post-operative complications occurred in 6 patients and mortality occurred in 2 [7.2%]. Mean post-operative follow up was 8.3 months and 10 years telephonic follow up completed in [32%] cases, with 2 late non-cardiac mortalities
Conclusion: Our results showed that the prevalence of cardiac myxoma is comparable with global estimates. Female gender was predominant and age and right atrial myxoma was slightly higher in our sample compare to other published literature. Myxoma can be excised successfully with a low rate of morbidity, mortality and recurrence
ABSTRACT
A 28-year-old woman presented with 3-month history of fever of unknown origin and progressively increasing cough. She was diagnosed with pulmonary tuberculosis on bronchial lavage cultures. A chest X-ray performed on follow-up showed a new opacity in the left apical area of the chest. Computed tomography scan of chest showed a large 10 cm pseudoaneurysm of the left subclavian artery 1 cm from its take off from the arch of the aorta. The pseudoaneurysm was approached through a left posterolateral thoracotomy and opened following a proximal and distal control. A 3 cm longitudinal defect was identified in the subclavian artery within its intrathoracic portion. This was debrided and repaired with an autologous pericardial patch. The patient had an uneventful recovery and remained well on follow-up