Mudassir Iqbal Dar, Abdul Bari Khan, Sadqa Aftab, Shamsunnisa Rashdi, Syed Aftab Mahmood.
Management of left atrial myxomas at Civil Hospital, Karachi.
Pak J Surg Jan ;24(1):42-5.

Objective: To study the outcome of the management of left atrial myxoma. Design & Duration: An observational case series from April 2000 to April 2007. Setting: Department of Cardiac Surgery, Civil Hospital, Karachi. Patients: Twelve patients with left atrial myxomas. Methodology: The diagnosis was made according to clinical presentation and echocardiographic examinations. Tumour excised under cardiopulmonary bypass using aortic and bicaval cannulation and moderate hypothermia. Variables noted were surgical approach, pathological findings and complications after surgery. Result: Of the 12 cases, six were male and six female, with a mean age of 33.67±6.05 years. Fatigue and fever were the most common general symptoms, and dyspnoea the most common cardiologic symptom. The pedunculated atrial tumours were excised by trans-septal approach; tumour size ranged between 1.5x1x0.7 cms to 9x8x6 cms and weight 3-140 gms. Histopathology confirmed the tumours as atrial myxomas. One patient died of cerebrovascular accident on the 3rd postoperative day. So far, there has been no recurrence of the tumours. Conclusion: Surgical treatment with wide excision of left atrial myxomas by trans-septal approach is a suitable approach with negligible chances of recurrence.

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