Conservative surgery for atrioventricular valve myxoma.
Patients with valvular myxoma are usually candidates for surgery because of the high incidence of life-threatening embolism. In some cases, the tumor is sessile or presents with a large peduncle: complete excision may then lead to valve replacement. We report two cases of atrioventricular valve myxoma where replacement was avoided. In one patient, a mitral myxoma appended from the edge of the anterior leaflet close to the chordae insertion; safe excision implied destruction of the two chordae and a peritumoral section of the anterior leaflet. A chordal transposition technique was used to preserve valve competence. In a second patient, a tricuspid myxoma causing syncopal episodes was resected; this was characterized by a large stalk, located on the anterior tricuspid leaflet away from chordal attachment and the valvular annulus. Treatment was by resection and the leaflet reconstructed with a pericardial patch. Techniques for conservative treatment of degenerative valvular disease or endocarditis, when monitored peroperatively by transesophageal echocardiography, may be successful in the surgical resection of atrioventricular myxoma.
Roques
F
F
Department of Cardiovascular Surgery, Fort de France University Hospital, Martinique, French West Indies.
Ulmer
B
B
Sanchez
B
B
Godreuil
J
J
Bernasconi
F
F
Smadja
D
D
Bucher
B
B
D000328:Adult; D005260:Female; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D009232:Myxoma / Q000000981:diagnostic imaging / Q000601:surgery*; D014463:Ultrasonography