Varied Presentation, Location and Outcomes in Management of Left Atrial Myxomas in a Tertiary Care Institution: A Case Series

Primary tumours of heart are a rare entity, and are mostly benign. Among them myxomas is the most common, typically Left Atrial (LA) arising from inter-atrial septum. Here we present a case series in which five patients were operated, of which four were female and one was male. The mean age was 57.4 +/- 16.1 years. Shortness of breath was the most common chief complaint followed by palpitation, altered sensorium. Majority of the patients belonged to NYHA II and III and ASA (American Society of Anaesthesiologists) 2 category. All were pedunculated masses. Of the masses three originated from interatrial septum, one from LA appendage, and another from the base of anterior mitral leaflet (aorto-mitral mitral junction). Transseptal approach, via right atrium was used in most cases. The mean cross clamp time was 50.6 minutes and cardiopulmonary bypass time was 80.2 minutes. The mean Vasoactive-Inotropic Score (VIS) was 8.6, and mean intensive care unit stay was 3.6 days. Besides a patient requiring tracheostomy, there were no other complications. They are easily diagnosed with echocardiography and once operated they have an excellent recovery, and remain symptom free.