RECHERCHES SCIENTIFIQUES

LES MYXOMES CARDIAQUES

Référence916
Année2015
TypeThèse
Lien document
AuteurEl aissaoui AE
DisciplineChirurgie Cardiovasculaire
EncadrantMessouak M

Introduction :The primary cardiac tumors are rare, mostly benign and largely dominated by the myxoma, which is an ongoing diagnostic challenge by its variables, non-specific and anatomically depending clinical expressions.The advent of ultrasound and extracorporeal circulation facilitated the diagnosis and the management. Pathological examination allows confirmation of the diagnosis.
Objectives :This study aims to report clinical particularities, treatment concepts, potential evolution related to cardiac myxoma to the light of our initial experience and reviewed of the literature.
Materials and methods : it’s about a retrospective study realized at the departement of cardiovascular surgery of the university hospital Hassan II-Fes, over a period of 6 years between the 01 January 2009 and the 31 December 2014. The study includes 14 patients; all of them have presented cardiac myxoma that required open heart surgery. All the patients who have responded to these criteria were included into this study.
Results :There were 11 women and 3 men; the mean age was 56 years (20-76 years). 86% of myxomas located on the left atrium, while 7% were located in the right atrium. We had also a case of localization in the aortic valve (7%).Concerning 13 of our patients (1 case of intraoperative discovery), the positive diagnosis was made by the demonstration of an intracardiac tumor on ultrasound, and has been consistently confirmed by histological study. Surgical approach was a right atriotomy in the 14 cases. We note Only one death by cardiovascular failure secondary to ischemic heart disease undiagnosed pre- op. The post-operative course being simple for the 13 remaining patients. During the clinical and sonographic follow-up, one case of medium-term recurrence occurred.
Conclusion :The myxoma is a rare primary tumor, often presented with polymorphic symptomatology (exertional dyspnea, palpitations, left heart failure presentation, positional syncope, systemic embolism, precordialgia and right heart failure presentation) its diagnosis is essentially based on the echocardiography. The left atrial localization is the most frequent, with a net female predominance. Treatment is always surgical, burdened with a low morbidity and mortality. The long-term evolution is usually favorable, however, recurrence is possible, justifying a regular ultrasound monitoring