• Abstract

    One frequent primary neoplasm of the heart is cardiac myxoma. Due to the possibility of embolization, they are "functionally malignant" yet physiologically benign. All of the chambers of the heart are susceptible, although the left atrium is where they often originate. As a component of the Carney complex, they are both familial and, in most cases, sporadic. There are two distinct morphological forms: papillary and polypoid. While papillary types of polypoid myxomas are more likely to embolize, they often exhibit obstructive characteristics. The current theory about the origin of histogenesis, which is still under debate, revolves around primitive pluripotent mesenchymal cells. They might be enormous in size, calcified, or diseased. The trifecta of intracardiac blockage, embolic events, and constitutional symptoms usually appear clinically. The results of a precordial examination might mimic those of tricuspid or mitral stenosis. The ability to distinguish between the two may be aided by the existence of tumor growth and changes in the physical findings with shifting posture. The preferred method of inquiry is echocardiography. The characteristic echocardiographic characteristics include an echogenic polypoid or a papillary movable mass within the atrial cavity that is still connected to the interatrial septum by a stalk. Computed tomography scanning and cardiac magnetic resonance imaging could be useful for further diagnosis. Numerous loose myxoid stroma with sporadic round, polygonal, or stellate cells with dense, irregular nuclei are shown by histopathological analysis. Genetic testing has the potential to identify mutations in the PRKAR1A gene in the Carney complex, which is the familial type of cardiac myxoma. The cornerstone of therapy is surgical excision, which has a low risk of recurrence, good postoperative survival, and minimal operational mortality. Minimal-access surgery, with or without robotic help, is the current trend. To prevent potentially deadly consequences, physicians should be appropriately equipped to make a prompt diagnosis and enthusiastic treatment.

  • References

    1. Murphy DA, Miller JS, Langford DA: Robot-assisted endoscopic excision of left atrial myxomas. J Thorac Cardiovasc Surg. 2005, 130:596-597. 10.1016/j.jtcvs.2004.12.005
    2. Yang M, Yao M, Wang G, et al.: Comparison of postoperative quality of life for patients who undergo atrial myxoma excision with robotically assisted versus conventional surgery. J Thorac Cardiovasc Surg. 2015, 150:152-157. 10.1016/j.jtcvs.2015.01.056
    3. Kadiroğulları E, Onan B, Aydın Ü, et al.: A comparison of robotically-assisted endoscopic versus sternotomy approach for myxoma excision: A single-center experience. Turk Gogus Kalp Damar Cerrahisi Derg. 2020, 28:450-459. 10.5606/tgkdc.dergisi.2020.19278
    4. Mohr FW, Falk V, Diegeler A, et al.: Computer-enhanced coronary artery bypass surgery. J Thorac Cardiovasc Surg. 1999, 117:1212-1214. 10.1016/S0022-5223(99)70261-8
    5. Autschbach R, Onnasch JF, Falk V, et al.: The Leipzig experience with robotic valve surgery. J Card Surg. 2000, 15:82-87. 10.1111/j.1540-8191.2000.tb00447.x
    6. Nifong LW, Chitwood WR, Pappas PS, et al.: Robotic mitral valve surgery: a United States multicenter trial. J Thorac Cardiovasc Surg. 2005, 129:1395-1404. 10.1016/j.jtcvs.2004.07.050
    7. Dogan S, Aybek T, Andressen E, et al.: Totally endoscopic coronary artery bypass grafting on cardiopulmonary bypass with robotically enhanced telemanipulation: report of forty-five cases. J Thorac Cardiovasc Surg. 2002, 123:1125-1131. 10.1067/mtc.2002.121305
    8. Bauernschmitt R, Feuerstein M, Traub J, et al.: Optimal port placement and enhanced guidance in robotically assisted cardiac surgery. Surg Endosc. 2007, 21:684-687. 10.1007/s00464-006-9057-z
    9. Mihaljevic T, Jarrett CM, Gillinov AM, et al.: Robotic repair of posterior mitral valve prolapse versus conventional approaches: potential realized. J Thorac Cardiovasc Surg. 2011, 141:72-80. 10.1016/j.jtcvs.2010.09.008
    10. Chitwood WR: Robotic mitral valve surgery: overview, methodology, results, and perspective. Ann Cardiothorac Surg. 2016, 5:544-555. 10.21037/acs.2016.03.16
    11. Cerny S, Oosterlinck W, Onan B, et al.: Robotic Cardiac Surgery in Europe: Status. Front Cardiovasc Med. 2021, 8:827515. 10.3389/fcvm.2021.827515
    12. Coyan G, Wei LM, Althouse A, et al.: Robotic mitral valve operations by experienced surgeons are cost-neutral and durable at 1 year. J Thorac Cardiovasc Surg. 2018, 156:1040-1047. 10.1016/j.jtcvs.2018.03.147
    13. Loulmet F, Carpentier A, d'Attellis N, et al.: Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments. J Thorac Cardiovasc Surg. 1999, 118:4-10. 10.1016/S0022-5223(99)70133-9
    14. Bonatti J, Bonaros N, Mueller S, Bartel T: Completely endoscopic removal of a dislocated Amplatzer atrial septal defect closure device. Interact Cardiovasc Thorac Surg. 2008, 7:130-132. 10.1510/icvts.2007.164517
    15. Bonatti J, Schachner T, Bonaros N, et al.: Robotic totally endoscopic coronary artery bypass and catheter based coronary intervention in one operative session. Ann Thorac Surg. 2005, 79:2138-2141. 10.1016/j.athoracsur.2003.12.074
    16. Loulmet D, Koeckert M, Neuburger P, Nampiaparampil R, Grossi E: Robotic mitral repair for Barlow's disease with bileaflet prolapse and annular calcification using pericardial patch technique. Ann Cardiothorac Surg. 2017, 6:67-69. 10.21037/acs.2017.01.09
    17. Bonatti J, Wallner S, Crailsheim I, Grabenwoger M, Winkler B: Minimally invasive and robotic coronary artery bypass grafting - a 25-year review. J Thorac Dis. 2021, 13:1922-1944. 10.21037/jtd-20-1535
    18. Thijs I, Fresiello L, Oosterlinck W, Sinnaeve P, Rega F: Assessment of physical activity by wearable technology during rehabilitation after cardiac surgery: explorative prospective monocentric observational cohort study. JMIR Mhealth Uhealth. 2019, 7:9865. 10.2196/mhealth.9865
    19. Gammie J, Zhao Y, Peterson E, O'Brien S, Rankin S, Griffith B: Less-invasive mitral valve operations: trends and outcomes from the society of thoracic surgeons adult cardiac surgery database. Ann Thorac Surg. 2010, 90:1401-1410. 10.1016/j.athoracsur.2010.05.055
    20. Kuo CC, Chang HH, Hsing CH, et al.: Robotic mitral valve replacements with bioprosthetic valves in 52 patients: experience from a tertiary referral hospital. Eur J Cardiothorac Surg. 2018, 54:853-59. 10.1093/ejcts/ezy134
    21. Wimmer-Greinecker G, Dogan S, Tayfun-Aybek T, et al.: Totally endoscopic atrial septal repair in adults with computer enhanced telemanipulation. J Thorac Cardiovasc Surg. 2003, 126:465-468. 10.1016/S0022-5223(03)00053-9
    22. Argenziano M, Oz M, Kohmoto T, et al.: Totally endoscopic atrial septal defect repair with robotic assistance. Circulation. 2003, 108:191-94. 10.1161/01.cir.0000089043.82199.2f
    23. Bonaros N, Schachner T, Oehlinger A, et al.: Robotically assisted totally endoscopic atrial septal defect repair: insights from operative times, learning curves, and clinical outcome. Ann Thorac Surg. 2006, 82:687-694. 10.1016/j.athoracsur.2006.03.024
    24. Kadirogullari E, Onan B, Timur B, et al.: Transcatheter closure vs totally endoscopic robotic surgery for atrial septal defect closure: a single-center experience. J Card Surg. 2020, 35:764-771. 10.1111/jocs.14456
    25. Jansens JL, Jottrand M, Preumont N, Stoupel E, De Canniere D: Robotic-enhanced biventricular resynchronization: an alternative to endovenous cardiac resynchronization therapy in chronic heart failure. Ann Thorac Surg. 2003, 76:413-417. 10.1016/S0003-4975(03)00435-1
    26. Bhatt AG, Steinberg JS: Robotic-assisted left ventricular lead placement. Heart Fail Clin. 2017, 13:93-103. 10.1016/j.hfc.2016.07.008
    27. Schill MR, Sinn LA, Greenberg JW, et al.: A minimally invasive stand-alone Cox-Maze procedure is as effective as median sternotomy approach. Innovations. 2017, 12:186-191. 10.1177/155698451701200304
    28. Rodriguez E, Cook RC, Chu MWA, Chitwood WR: Minimally invasive bi-atrial cryomaze operation for atrial fibrillation. Oper Tech Thorac Cardiovasc Surg. 14:208-23. 10.1053/j.optechstcvs.2009.06.009
    29. Van den Eynde J, Melly L, Torregrossa G, Oosterlinck W: Robotic cardiac surgery: what the young surgeon should know. Braz J Cardiovasc Surg. 35:6-8. 10.21470/1678-9741-2020-0437
    30. Valdis M, Chu MW, Schlachta C, Kiaii B: Evaluation of robotic cardiac surgery simulation training: a randomized controlled trial. J Thorac Cardiovasc Surg. 151:1498-505. 10.1016/j.jtcvs.2016.02.016
    31. Barbash GI, Glied SA: New technology and health care costs-the case of robot-assisted surgery. N Engl J Med. 2010, 363:701-704. 10.1056/NEJMp1006602
    32. Morgan JA, Thornton BA, Peacock JC, et al.: Does robotic technology make minimally invasive cardiac surgery too expensive? A hospital cost analysis of robotic and conventional techniques. J Card Surg. 2005, 20:246-251. 10.1111/j.1540-8191.2005.200385.x
    33. Manduz S, Katrancioglu N, Karahan O, Yucel O, Yilmaz MB: Diagnosis and follow up of patients with primary cardiac tumours: a single-centre experience of myxomas. Cardiovasc J Afr. 2011, 22:310-312. 10.5830/CVJA-2010-073
    34. Islam KS: A Snapshot on Myxoma Operation of 62 Patients at National Institute of Cardiovascular Diseases(NICVD), Dhaka, Bangladesh. Bangladesh heart Journal. 2018, 28:85-99. 10.3329/bhj.v33i2.39302
    35. Bossert T, Gummert JF, Battellini R, et al.: Surgical experience with 77 primary cardiac tumors. Interact Cardiovasc Thorac Surg. 2005, 4:311-315. 10.1510/icvts.2004.103044
    36. Glancy DL, Morales JB, Roberts WC: Angiosarcoma of the heart. Am J Cardiol. 1968, 21:413-419. 10.1016/0002-9149(68)90144-6
    37. Cianciulli TF, Cozzarin A, Soumoulou JB, et al.: Twenty Years of Clinical Experience with Cardiac Myxomas: Diagnosis, Treatment, and Follow Up. J Cardiovasc Imaging. 2019, 27:37-47. 10.4250/jcvi.2019.27.e7
    38. Lukacs L, Lengyel M, Szedo F, et al.: Surgical treatment of cardiac myxomas: a 20-year follow-up. Cardiovasc Surg. 1997, 5:225-228. 10.1016/S0967-2109(96)00084-1
    39. Butany J, Nair V, Naseemuddin A, Nair GM, Catton C, Yau T: Cardiac tumours: diagnosis and management. Lancet Oncol. 2005, 6:219-228. 10.1016/S1470-2045(05)70093-0
    40. Sharma J, Sherchan S, Pradhan S, et al.: Primary Cardiac Tumours: Our Experience. Nepalese Heart Journal. 2013, 21:8-11. 10.3126/njh.v8i1.8329
    41. Keeling IM, Oberwalder P, Anelli-Monti M, et al.: Cardiac myxomas: 24 years of experience in 49 patients. Eur J Cardiothorac Surg. 2002, 22:971-977. 10.1016/S1010-7940(02)00592-4
    42. Castells E, Ferran V, Octavio de Toledo MC, et al.: Cardiac myxomas: surgical treatment, long-term results and recurrence. J Cardiovasc Surg. 1993, 34:49-53.
    43. Mandal SC, Islam MS, Rushel K, et al.: Cardiac Myxoma-17 Years Experience in a Tertiary Care Centre of Bangladesh. Bangladesh Heart Journal. 2018, 10:85-88. 10.3329/bhj.v32i2.36093
    44. Khan MS, Sanki PK, Hossain MZ, Charles A, Bhattacharya S, Sarkar UN: Cardiac myxoma: A surgical experience of 38 patients over 9 years, at SSKM hospital Kolkata, India. South Asian J Cancer. 2013, 2:83-86. 10.4103/2278-330X.110499
    45. Sultan FA, Syed A, Kazmi K, Dhakam S: Cardiac myxomas--clinical spectrum and outcome. J Coll Physicians Surg Pak. 2006, 16:501-503.
    46. Karabinis A, Samanidis G, Khoury M, Stavridis G, Perreas K: Clinical presentation and treatment of cardiac myxoma in 153 patients. Medicine. 2018, 97:12397. 10.1097/MD.0000000000012397
    47. Bjessmo S, Ivert T: Cardiac myxoma: 40 years' experience in 63 patients. Ann Thorac Surg. 1997, 63:697-700. 10.1016/S0003-4975(96)01368-9
    48. Yuksel A, Saba D, Velioglu Y, Ener S, Ozkan H: Biatrial Approach Provides Better Outcomes in the Surgical Treatment of Cardiac Myxomas. Braz J Cardiovasc Surg. 2016, 31:309-17. 10.5935/1678-9741.20160066
    49. Lee KS, Kim GS, Jung Y, et al.: Surgical resection of cardiac myxoma-a 30-year single institutional experience. J Cardiothorac Surg. 2017, 27:18. 10.1186/s13019-017-0583-7

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Sarode, A., Kumar, K., & Sarode, R. (2024). Revolutionizing cardiac urgery: Da Vinci robotic system in atrial myxoma treatment. Multidisciplinary Reviews, (| Accepted Articles). Retrieved from https://malque.pub/ojs/index.php/mr/article/view/2989
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