WENG Jiakan,JIN Peifeng,SUN Chengchao. The surgical treatment of giant left atrial myxoma with mitral regurgitation[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2016, 46(6): 442-446.
Abstract：Objective: To summarize our clinical data of left atrial (LA) myxoma patients with mitral regurgitation (MR) which found in surgery, in order to discuss the clinical characteristics, mechanism and treatment of MR. Methods: From July 2006 to July 2014, 50 patients were diagnosed with LA myxoma and underwent surgical treatment at the First Affiliated Hospital of Wenzhou Medical University, which contained 10 cases who underwent tumor resection with mitral valve surgery. The surgeons should perform a careful inspection of the mitral valve after tumor resection and use intraoperative transesophageal echocardiography (TEE) to evaluate the mitral valve. If the dysfunction of leaflet or annular of mitral valve leads severe MR, the surgeons should perform mitral valve surgery after tumor resection. All patients were followed up more than 1 year to evaluate the outcomes of myxoma resection and mitral valve surgery and complications. Results: We found moderate to severe MR when the huge tumors [(5.0±1.9) cm×(4.1±1.0 cm)] were resected in 10 cases who underwent tumor resection with mitral valve surgery, severe MR was not mentioned in 9 cases before operation among them. We performed mitral valve reconstruction on 9 patients and mitral valve replacement on 1 patient. There was no operative death. During follow-up, there was no death, reoperation and myxoma recurrence, we also found 0 cases of moderate to severe MR. Conclusion: We suggested that the surgical team should be aware of LA myxoma with MR during the operation, especially the tumor is large. The surgeons should perform a careful inspection of the mitral valve and use TEE to detect the mitral valve dysfunction timely and evaluate the outcomes of operation. If the dysfunction of leaflet or annular of mitral valve leads severe MR, we recommended the surgeons should perform mitral valve reconstruction firstly after tumor resection.
