ABSTRACT
Tricuspid valve myxoma is extremely rare. A 33-year-old woman who had undergone clipping of a cerebral aneurysm, had a cardiac tumor pointed out incidentally while undergoing echocardiography. Echocardiography showed a mobile and solid round mass (14×12 mm) attached by a short stalk. We suspected a right ventricular tumor. Once the diagnosis of cardiac tumor has been established, prompt excision is essential to prevent complications, as well as syncope or collapse due to the transient occlusion of the tricuspid or pulmonary valves with embolization by the thrombus or fragments of the tumor tissue. Surgery was performed under cardiopulmonary bypass. The tumor was attached to the anterior papillary muscle and chordae of the tricuspid valve. The tumor was extirpated along with a piece of the papillary muscle and chordae. We performed tricuspid chordoplasty with artificial chordae. The histopathologic diagnosis was myxoma. The postoperative course was uneventful and the patient was discharged on the 15th day after the operation. While the patient has done well with no recurrence of the tumor during the five years that have passed since her operation, we will continue to observe her closely in the future because there have been some reports of recurrence after complete excision of cardiac myxoma and there are no long-term follow-up results of artificial chordae in the tricuspid position.
ABSTRACT
A 76-year-old-woman, who had undergone endoscopic resection of a gastric polyp 2 years previously, had a cardiac tumor incidentaly pointed out on an abdominal ultrasonographic image. Echocardiography showed a solid round mass (34×25 mm in diameter), attached by a short stalk and which was floating on the right ventricular outflow tract and prolapsing over the pulmonary valve during systole. We suspected right ventricular myxoma. Urgent surgery was performed under cardiopulmonary bypass. After aortic clamping, the trunk of the pulmonary artery was opened near the right ventricule. The tumor was found under the pulmonary valve, attached to the anterior papillary muscle and chordae of the tricuspid valve. The tumor was completely excised with a piece of the papillary muscle and chordae. After right atriotomy, mild tricuspid regurgitation was seen on a water test. After we performed tricuspid annuloplasty and chordplasty with artificial chordae, a second water test did not show any tricuspid regurgitation. The postoperative course was uneventful, and she was discharged on the 13th postoperative day.