Cardiac myxomas causing chamber obstruction: report of two clinical cases and surgical management
DOI:
https://doi.org/10.14739/2310-1237.2026.1.341150Keywords:
transthoracic echocardiography, cardiac neoplasm, hemodynamic instability, tumor resection, histopathological examinationAbstract
Primary cardiac tumors are rare, and myxomas account for the majority of benign neoplasms. In uncommon cases, large myxomas can cause significant intracardiac hemodynamic disturbances that mimic valvular defects, heart failure, or thromboembolic conditions. Timely diagnosis and appropriate surgical management are essential to prevent life-threatening complications.
Aim. To analyze the features of intracardiac hemodynamics in patients with myxomas causing chamber obstruction and to present own clinical observations for evaluating the effectiveness of surgical tactics.
Materials and methods. Two clinical cases of large cardiac myxomas causing obstruction of the left and right heart chambers are presented. A comprehensive assessment of clinical symptoms, instrumental studies (transthoracic and transesophageal echocardiography, CT angiography), and surgical outcomes was performed. Histopathological verification of the diagnosis was obtained through microscopic examination of the resected tumors.
Results. In both patients, giant myxomas with pronounced outflow obstruction were identified, manifesting with severe dyspnea, pulmonary hypertension, and signs of congestive heart failure. Both patients underwent successful surgery: in the first case – a left atrial myxoma prolapsing into the left ventricular outflow tract, and in the second – a multilobular right atrial myxoma obstructing the inferior vena cava and the right atrioventricular orifice. The use of parallel cardiopulmonary bypass and individually selected surgical access ensured complete tumor excision and stabilization of hemodynamics without postoperative complications. Histopathological examination confirmed the benign nature of the tumors.
Conclusions. Giant cardiac myxomas causing hemodynamically significant chamber obstruction can lead to severe heart failure and pose an immediate threat to life. Echocardiography remains the leading diagnostic method that allows determining the size, location, and mobility of the tumor. Surgical resection with subsequent histopathological verification is the treatment of choice, providing high survival rates and a minimal risk of recurrence.
References
- Bussmann B, Shabbir A, Stirrup J. Giant left atrial myxoma with mitral valve orifice obstruction. Eur Heart J Case Rep. 2022;6(3):ytac103. doi: https://doi.org/10.1093/ehjcr/ytac103
| 
| 
- Hibatouallah H, Mehssani Z, Sayah R, Fellat R, Fellat N. Giant right atrial Myxoma associated with acute coronary syndrome. Oxf Med Case Reports. 2026;2026(1):omaf193. doi: https://doi.org/10.1093/omcr/omaf193
| | - Koritnik P, Pavsic N, Bervar M, Prokselj K. Echocardiographic characteristics of cardiac myxoma. Eur Heart J. 2021;42(Suppl 1):ehab724.0146. doi: https://doi.org/10.1093/eurheartj/ehab724.0146
- Scalise M, Torella M, Marino F, Ravo M, Giurato G, Vicinanza C, et al. Atrial myxomas arise from multipotent cardiac stem cells. Eur Heart J. 2020;41(45):4332-45. doi: https://doi.org/10.1093/eurheartj/ehaa156
| | - Jaravaza DR, Lalla U, Zaharie SD, de Jager LJ. Unusual presentation of atrial myxoma: a case report and review of the literature. Am J Med Case Rep. 2021;22:e931437. doi: https://doi.org/10.12659/AJCR.931437
| | - D’Anna C, Villani A, Ammirati A, Francalanci P, Ragni L, Cecconi G, et al. New Onset Cardiac Murmur and Exertional Dyspnea in an Apparently Healthy Child: A Rare Localization of Obstructive Myxoma in the Right Ventricle Outflow Tract without Pulmonary Embolization-A Case Report and Literature Review. Int J Environ Res Public Health. 2022;19(19):12888. doi: https://doi.org/10.3390/ijerph191912888
| | - Oktaviono YH, Saputra P, Arnindita JN, Afgriyuspita LS, Kurniawan RB, Pasahari D, et al. Clinical characteristics and surgical outcomes of cardiac myxoma: a meta-analysis of worldwide experience. Eur J Surg Oncol. 2023;50(2):107940. doi: https://doi.org/10.1016/j.ejso.2023.107940
| | - Griborio-Guzman AG, Aseyev OI, Shah H, Sadreddini M. Cardiac myxomas: clinical presentation, diagnosis and management. Heart. 2022;108(11):827-33. doi: https://doi.org/10.1136/heartjnl-2021-319479
| | - Abdelazeem B, Khan H, Changezi H, Munir A. A giant left atrial myxoma causing mitral valve pseudostenosis – a mimicker. J Community Hosp Intern Med Perspect. 2021;11(4):523-7. doi: https://doi.org/10.1080/20009666.2021.1930867
| - Bahloul A, Sarray H, Kammoun Y, Charfeddine S, Gueldich M, Dammak A, et al. Giant left atrial myxoma with mitral valve obstruction. J Cardiovasc Echogr. 2021;31(2):110-2. doi: https://doi.org/10.4103/jcecho.jcecho_111_20
| | - Islam AK. Cardiac myxomas: a narrative review. World J Cardiol. 2022;14(4):206-19. doi: https://doi.org/10.4330/wjc.v14.i4.206
| | - Silva Júnior ML, Albuquerque TE, Melo ES. Giant atrial myxoma leading to stroke. Med J Aust. 2021;215(6):258-258.e1. doi: https://doi.org/10.5694/mja2.51231
| | - Yasin Y, Darwazah AK, Rajabi I, Al-Ali FH, Subhi R, Hasani A, et al. Large ventricular myxoma causing inflow and outflow obstruction of the right ventricle; A Case Report. J Cardiothorac Surg. 2024;19(1):540. doi: https://doi.org/10.1186/s13019-024-03056-4
| | - Abdumajidov K, Buranov K. Giant myxoma of the right sections of the heart obstructing the inferior vena cava: A case report. Hear Vessel Transpl. 2023;7(4):382. doi: https://doi.org/10.24969/hvt.2023.405
| - Hasan M, Abdelmaseih R, Faluk M, Chacko J, Nasser H. Atrial myxoma, a rare cause of sudden cardiac death: a case report and review of literature. Cureus. 2020;12(1):e6704. doi: https://doi.org/10.7759/cureus.6704
| - Děrgel M, Gofus J, Smolák P, Stejskal V, Hanke I, Matějka J, et al. Surgical treatment of primary cardiac tumors: 20-year single-center experience. Kardiochir Torakochirurgia Pol. 2022;19(1):36-40. doi: https://doi.org/10.5114/kitp.2022.114553
| | - Yin Y, Deng J, Liu Y, Zheng J, Zhang Y, Bai Q, et al. Two cases of atrial myxoma with calcification and ossification as the main features. J Cardiothorac Surg. 2024;19(1):388. doi: https://doi.org/10.1186/s13019-024-02876-8
| | - Kuplay H, Kurç E, Mete EM, Kuş Z, Erdoğan SB, Akansel S, et al. Early and late results in surgical excision of primary cardiac tumors: our single-institution experience. Turk Gogus Kalp Damar Cerrahisi Derg. 2018;26(2):177-82. doi: https://doi.org/10.5606/tgkdc.dergisi.2018.14985
| | - Lu C, Yang P, Hu J. Giant right ventricular myxoma presenting as right heart failure with systemic congestion: a rare case report. BMC Surg. 2021;21(1):64. doi: https://doi.org/10.1186/s12893-020-00977-4
| | - Spartalis M, Tzatzaki E, Spartalis E, Moris D, Athanasiou A, Kyrzopoulos S, et al. Atrial myxoma mimicking mitral stenosis. Cardiol Res. 2017;8(3):128-30. doi: https://doi.org/10.14740/cr558w
|
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Copyright (c) 2026 V. V. Osaulenko, V. O. Hubka, K. O. Chmul, S. Yu. Nakonechnyi, R. I. Budahov, Yu. M. Avramenko
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