Discussion
Although myxomas are the most commonly seen primary cardiac tumors, they
remain a very rare. The presenting symptoms of an atrial myxoma are
widely variable and non-specific. Regardless of presentation, once a
diagnosis is made urgent surgical excision is recommended to avoid the
potential complications [12]. So, we reported small number
of cases during long period. All patients were discovered incidentally
during TTE examination.
Around 30% of the patients presented with signs and symptoms associated
with secondary embolization [13]. So, once diagnosis was
done surgical excision was performed to avoid incurable complications.
Biatrial exposure has been the preferred approach for complete surgical
excision. MI approach has been increasingly used in the field of cardiac
surgery [4-5]. In our study, we used to right atriotomy
trans-septal approach for LA myxomas.
Accurate imaging of cardiac myxomas before surgical resection is
critical for operative success. Myxomas are often detected with
echocardiography, CT, or CMR [11] . Echocardiography serves
as a cornerstone of workup in the evaluation of ischemic stroke, as
(15%) are cardiac causes [14] . We reported only two cases
done MRI after TTE diagnosis. Advanced diagnostic imaging helped us to
be ensured there were not multiple myxomas, that were needed more
exploration.
Surgical excision is the treatment of choice for atrial myxoma resulting
in a complete cure (99%), and recurrence in (1%) [15] .
Incomplete resection of the myxoma attachment area is considered the
common cause of recurrence [16] .So, we excised myxoma with
its interatrial septal attachment the repair the defect.
When compared with a median ST approach, the reported benefits of MICS
include reduced; surgical trauma, blood loss, need for reoperation, and
pain, early return to normal daily activity, shorter ICU and hospital
stays, reduced costs, and higher level of patient′s satisfaction[8]. We reported in our study that MI approach reduced time
of hospital stay, no reopening due to bleeding, better cosmetic wound
appearance, and more patient′s satisfaction.