Abstract
Objective – analysis of the immediate results of surgical treatment of atypically localized myxomas (ALM) in comparison with typically localized myxomas (TLM).
Material and methods. A retrospective review of all cardiac myxomas (n=113) resulting from surgical removal from 2008 to 2022 was performed. Patients were divided into two groups depending on the place of myxoma origin: group I – atypically localized myxomas, group II – typically localized myxomas.
Results. In the ALM group, there are 2 times more patients with respiratory failure in the perioperative period than in the TLM group (p=0.049). This is due to the large number of patients with pulmonary hypertension (PH) in the ALM group. There were more mitral valve replacements and LA reconstructions in the ALM group than in the TLM group (p=0.02 and p=0.046, respectively). In the TLM group at the hospital stage, all patients with postoperative atrial fibrillation (AF) (6 patients) were restored to sinus rhythm before discharge. In the ALM group, there were 7 cases of rhythm disturbance (RD) after surgery. Of these, only 2 had a history of RD by type of AF. In 5 patients with postoperative arrhythmias in the ALM group, and in two patients in the TLM group, access to the left heart was carried out using Guiraudon. In the ALM group, 3 patients (5.8%) died, in the TLM group there were no lethal cases (p=0.057).
Conclusion. In the surgical treatment of a mix with atypical localization, all patients at the preoperative stage are shown a thorough diagnosis to select the optimal access to the tumor and reduce trauma. Once a myxoma is identified, it is important to perform surgical resection as soon as possible before the development of serious irreversible complications, which can provide a rapid regression of the symptoms of congestive heart failure. In secondary functional insufficiency ≥ 2 degrees, the reconstruction of the atrioventricular valves at the same time as the removal of the neoplasm of the heart plays an important role in the normalization of intracardiac hemodynamics.
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About the authors
- Tel’man A. Simonyan, Researcher; ORCID
- Leo A. Boсkeria, Academician of RAS, President of the Center; ORCID
- Ivan I. Skopin, Dr. Med. Sci., Professor, Corresponding Member, RAS, Director of Institute for Coronary and Vascular Surgery; ORCID
- Irma M. Tsiskaridze, Cand. Med. Sci., Senior Researcher; ORCID
- Pavel V. Kakhktsyan, Cand. Med. Sci., Cardiovascular Surgeon; ORCID
- Inga Yu. Farulova, Cand. Med. Sci., Senior Researcher, Ultrasound Diagnostician; ORCID
- David R. Tevosov, Junior Researcher; ORCID
- Magomed S. Ibragimov, Postgraduate; ORCID
- Dil’noza G. Shamsieva, Resident; ORCID
- Beka A. Sulakadze, Cardiovascular Surgeon; ORCID
