Key result
Surgical resection of cardiac myxoma during pregnancy was performed in 95.9% of cases with no maternal deaths, and 76.9% of neonates in the delivery group had event-free survival.
Why the study?
Does surgical resection of cardiac myxoma in pregnant patients result in favorable maternal and feto-neonatal outcomes?
Does surgical resection of cardiac myxoma in pregnant patients result in favorable maternal and feto-neonatal outcomes?
Surgical treatment of cardiac myxoma during pregnancy is associated with favorable maternal outcomes and acceptable feto-neonatal survival.
Supports surgical management of cardiac myxoma in pregnancy; leaves open optimal timing and neonatal strategies pending prospective data.
OBJECTIVE: Cardiac myxoma in pregnancy is rare and the clinical characteristics of this entity have been insufficiently elucidated. This article aims to describe the treatment options and the risk factors responsible for the maternal and feto-neonatal prognoses. METHODS: A comprehensive search of the literature of cardiac myxoma in pregnancy was conducted and 44 articles with 51 patients were included in the present review. RESULTS: Transthoracic echocardiography was the most common diagnostic tool for the diagnosis of cardiac myxoma during pregnancy. Cardiac myxoma resection was performed in 95.9% (47/49); while no surgical resection was performed in 4.1% (2/49) patients (P=0.000). More patients had an isolated cardiac myxoma resection in comparison to those with a concurrent or staged additional cardiac operation [87.2% (41/47) vs. 12.8% (6/47), P=0.000]. A voluntary termination of the pregnancy was done in 7 (13.7%) cases. In the remaining 31 (60.8%) pregnant patients, cesarean section was the most common delivery mode representing 61.3% and vaginal delivery was more common accounting for 19.4%. Cardiac surgery was performed in the first, second and third trimester in 5 (13.9%), 14 (38.9%) and 17 (47.2%) patients, respectively. No patients died. In the delivery group, 20 (76.9%) neonates were event-free survivals, 4 (15.4%) were complicated and 2 (7.7%) died. Neonatal prognoses did not differ between the delivery modes, treatment options, timing of cardiac surgery and sequence of cardiac myxoma resection in relation to delivery. CONCLUSION: The diagnosis of cardiac myxoma in pregnancy is important. Surgical treatment of cardiac myxoma in the pregnant patients has brought about favorable maternal and feto-neonatal outcomes in the delivery group, which might be attributable to the shorter operation duration and non-emergency nature of the surgical intervention. Proper timing of cardiac surgery and improved cardiopulmonary bypass conditions may result in even better maternal and feto-neonatal survivals.
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Shi‐Min Yuan (2015) conducted a review in Cardiac myxoma in pregnancy (n=51). Surgical resection of cardiac myxoma was evaluated on Maternal and feto-neonatal prognoses. Surgical resection of cardiac myxoma during pregnancy was performed in 95.9% of cases with no maternal deaths, and 76.9% of neonates in the delivery group had event-free survival.
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