Intracardiac masses in western black sea region and our surgical experience

Objective: We aimed to report our surgical experience and outcomes in patients operated for intracardiac mass in our clinic. Materials and Methods: Six patients were operated for an intracardiac mass between May 2006 and March 2015. Five patients were female and 1 was male; the mean age of the study population was 54 (34-82) years. One patient presented with dyspnea and tachycardia secondary to pulmonary thromboembolism (PTE) and one patient with syncope, while the other patients presented with constitutional symptoms such as fatigue and dyspnea. Definitive diagnosis was made by a combination of thoracoabdominal tomography (CT) and echocardiography in one patient, and transthoracic echocardiography (TTE) and/or transesophageal echocardiography (TEE) in the remaining patients. The time from the diagnosis to the operation of masses was 2.5 days (1-4 days) on average. Four patients aged over 45 years underwent coronary angiography, irrespective of gender. The operations were performed via cardiopulmonary bypass, under standard aorta bicaval cannulation, antegrade cold blood cardioplegia, and moderate hypothermia. All defects in the patients with the initial diagnosis of cardiac myxoma were primarily closed. One patient was operated for a right atrial mass (thrombus). None of the patients suffered an intraoperative complication. The patients were discharged after an average of 9.6 days. Results: Histopathological diagnosis was a thrombus secondary to hypercoagulopathy related to antipsychotic drug use in one patient, and myxoma in the other patients. All myxomas were located in the left atrium while thrombi were in the right atrium, extending to the inferior vena cava. None of the patients had a family history for intracardiac mass. All patients enjoyed a clear clinical benefit upon mass removal. No early or late-term mortality was observed. There were no recurrences between 1 to 106 months (17.6 months on average) during early or late follow-up. Conclusion: Intracardiac masses, with myxomas being in the first place, may cause embolism, syncope, palpitations, and dyspnea; they should thus be remembered in the differential diagnosis of other intracardiac pathologies and operated at an early stage as soon as they are diagnosed; the tumor mass should be totally excised with a wide resection.