Introduction
A myxoma is the most common non-cancerous (benign) tumour of the heart. It usually grows in the left upper chamber (left atrium), attached to the wall by a stalk.
Even though it is not cancer, a myxoma can block blood flow, damage heart valves or break off small pieces that travel to the brain or other organs. For this reason, surgery to remove it is usually advised soon after it is found.
Why the procedure is needed
Depending on its size and position, a myxoma may cause:
- Breathlessness, particularly when lying flat or on effort, if it blocks the valve opening
- Dizziness or fainting, if it intermittently blocks the blood flow
- Stroke, vision problems or other sudden symptoms, if fragments travel in the bloodstream (embolism)
- Fever, weight loss, tiredness and other general symptoms in some patients
- Heart murmurs and rhythm problems
Who may benefit
- People in whom echocardiography, CT or MRI has shown a heart tumour that looks like a myxoma
- Patients with symptoms, or with signs of embolism, who usually need prompt surgery
- Patients without symptoms, in whom the risk of embolism or blockage still makes surgery advisable
- Patients with other heart tumours may need different assessment and treatment decisions
What the operation involves
- Complete removal
- The tumour, with the part of the heart wall where it is attached, is removed carefully and completely, to lower the chance that it returns.
- Gentle handling
- The tumour is handled carefully because pieces can break off, so the surgeon avoids squeezing or breaking it.
- Repair of the wall
- The area of the heart wall where the stalk was attached may be closed with stitches or a patch.
- Valve repair
- If the tumour has damaged a nearby valve, the valve may be repaired at the same time.
- Pathology and follow-up
- The tumour is examined under the microscope. Regular follow-up echocardiograms check for recurrence, which is uncommon, especially if the myxoma runs in the family.
Procedure overview
Step 1: Diagnosis
Echocardiography, often with CT or MRI, shows the size and attachment of the tumour. Blood tests and a check of the brain and other organs may be done if embolism is suspected.
Step 2: Anaesthesia
General anaesthesia is used.
Step 3: Surgical access
The heart is reached through the breastbone, and in selected cases through smaller incisions. The heart-lung machine takes over circulation.
Step 4: Excision
The chamber is opened and the tumour is removed together with its attachment area. The area is checked to ensure nothing is left behind.
Step 5: Repair and closure
The wall defect and any damaged valve are repaired, the chamber is closed, and the heart is restarted.
Step 6: Recovery and follow-up
Intensive-care monitoring is followed by ward recovery. Echocardiograms are done at regular intervals for years to watch for recurrence.
Clinical advantages
- Removes the tumour and the risk of blockage or embolism
- Usually relieves symptoms caused by the tumour
- Outcomes after complete removal of a myxoma are generally good
- Allows diagnosis by examining the tumour
Risks and considerations
Every operation carries risk. The points below are general; your own risk depends on your health and on the operation you need.
- General risks of open-heart surgery: bleeding, infection, rhythm problems, stroke and kidney problems
- Embolism (loose fragments) during surgery, which the surgeon works to avoid
- Recurrence of the tumour, particularly in familial cases, which is why follow-up is needed
- Damage to a valve or the heart wall that needs repair
- Risk depends on the size and location of the tumour and on your general health
Frequently asked questions
Is a myxoma cancer?
No. A myxoma is a benign tumour, but it can still cause serious problems because of its position in the heart, so removing it is usually advised.
Can it be treated with medicines?
No. Medicines cannot dissolve a myxoma. Surgery is the treatment.
Can the tumour come back?
Recurrence is uncommon but possible, particularly in some familial cases. That is why regular echo follow-up is advised.
How soon should it be removed?
Usually soon after diagnosis, because of the risk of blockage or embolism. Your surgeon will advise on timing.
How long is the recovery?
Hospital stay is often about a week, with recovery over several weeks, but this varies by patient.
Patient-friendly summary
Myxoma excision is open-heart surgery to remove a usually non-cancerous heart tumour before it blocks blood flow or sends pieces to the brain and other organs. Results are generally good after complete removal, and regular echo follow-up is advised afterwards. The timing and plan belong to a cardiologist and cardiothoracic surgeon.