A myxoma is a non-cancerous growth that typically forms within the heart’s upper chambers, known as the atria.
Understanding Myxomas and Their Necessity for Removal
Myxomas are the most common type of primary heart tumor, with about 75% originating in the left atrium. While benign, their presence can lead to significant health complications. A myxoma can obstruct blood flow within the heart, potentially causing symptoms such as shortness of breath, dizziness, or fainting. It can also cause symptoms resembling heart failure.
Beyond obstruction, fragments of a myxoma can break off and travel through the bloodstream, a process called embolization. These emboli can lodge in arteries elsewhere in the body, potentially causing a stroke if they reach the brain, or blockages in other organs. This risk of systemic embolization and blood flow obstruction makes surgical removal a necessary intervention to prevent life-threatening events.
Preparing for Myxoma Excision
Before myxoma excision, several diagnostic procedures accurately locate and characterize the tumor. Echocardiography, which uses sound waves to create images of the heart, is the primary diagnostic tool to visualize the myxoma and assess its size and attachment. Transesophageal echocardiography, where a probe is guided down the esophagus, provides an even clearer view of the heart’s structures.
Magnetic resonance imaging (MRI) or computed tomography (CT) scans may also provide more detailed anatomical information, helping surgeons plan the precise approach for removal. These imaging tests help the medical team understand the tumor’s exact location, its attachment site, and its relationship to surrounding heart structures. Alongside imaging, a comprehensive general health evaluation, including blood tests and an electrocardiogram, ensures the patient is medically prepared for the procedure.
The Surgical Removal Process
Surgical removal of a myxoma typically involves open-heart surgery, beginning with general anesthesia to ensure the patient is unconscious and pain-free. A median sternotomy is then performed, involving an incision down the center of the chest and dividing the breastbone to access the heart. This approach provides the surgeon with a clear and direct view.
After the chest is opened, the patient is connected to a heart-lung bypass machine. This machine temporarily takes over the functions of the heart and lungs, circulating oxygenated blood throughout the body while the heart is stopped. This allows the surgeon to operate on a still, bloodless heart, which is crucial for precision in cardiac surgery. The heart is then opened, usually through an incision in the right atrium or directly into the left atrium, depending on the tumor’s location.
The surgeon excises the myxoma, along with a small margin of surrounding tissue, to ensure complete removal and minimize the risk of recurrence. The tumor’s attachment site is also examined and treated, often by excising a small piece of the heart wall or using a technique to cauterize the area. After the myxoma is removed, the incisions in the heart are carefully closed with sutures. The heart-lung bypass machine is then gradually weaned off, allowing the heart to resume its normal function.
Recovery and Follow-Up Care
Following myxoma removal surgery, patients are typically transferred to an intensive care unit (ICU) for close monitoring during the initial recovery phase. In the ICU, vital signs such as heart rate, blood pressure, and oxygen levels are continuously observed, and pain management is provided. The typical ICU stay can range from one to three days.
Once stable, patients are moved to a regular hospital ward, where they continue to recover and begin light mobilization, such as walking short distances. The total hospital stay after surgery usually lasts between five and ten days. Before discharge, patients receive instructions on wound care, activity restrictions, and medication schedules.
Long-term follow-up care is important to monitor the heart’s function and to detect any potential recurrence, although myxoma recurrence is uncommon. Regular check-ups with a cardiologist are scheduled, often including follow-up echocardiograms to visualize the heart and ensure its continued health. These follow-up appointments typically occur at increasing intervals over several years for ongoing monitoring.