Atrial myxoma
- Overview
- Theory
- Diagnosis
- Management
- Follow up
- Resources
Treatment algorithm
Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups: see disclaimer
surgical candidate
myxoma resection (atriotomy)
Generally, after median sternotomy, the myxoma is surgically excised using cardiopulmonary bypass and cardioplegic arrest. The tumour is removed by either right or left atriotomy or combined atriotomy, depending on the site and extent of the tumour.
The choice of technique also depends on associated conditions that need surgical intervention, such as valve repair or replacement, and coronary artery bypass graft.
valve repair/replacement and/or coronary artery bypass graft
Additional treatment recommended for SOME patients in selected patient group
The choice of surgical technique depends on associated conditions that need surgical intervention, such as valve repair or replacement, and coronary artery bypass graft.
post-operative aspirin or anticoagulation
Additional treatment recommended for SOME patients in selected patient group
Post-operatively, there is no definitive recommendation for anticoagulation if the myxoma is removed. However, post-operative aspirin or anticoagulation should be considered if an embolic event has occurred or if there are other indications for such therapy, though the evidence base for such an approach is lacking. Consult your local protocols for guidance on choice of agent and dose.
treatment for dysrhythmia, embolisation, and/or heart failure
Additional treatment recommended for SOME patients in selected patient group
If there is any associated condition (e.g., arrhythmias), then medicines may be needed to control the arrhythmias until surgery. If there is any evidence of residual heart failure, then appropriate long-term therapies (e.g., beta-blockers, ACE inhibitors, and furosemide) may be needed in individual cases.
non-surgical candidate
treatment for dysrhythmia, embolisation, and/or heart failure
Those who have extensive comorbidity with poor prognosis and likely to succumb to cardiac surgery are not good candidates.
If there is any associated condition (e.g., arrhythmias), then medicines may be needed to control the arrhythmias. If there is any evidence of residual heart failure, then appropriate long-term therapies (e.g., beta-blockers, ACE inhibitors, and furosemide) may be needed in individual cases.
The role of anticoagulation in these patients is not established, hence this should be individualised. Aspirin is not routinely recommended for these patients.
Choose a patient group to see our recommendations
Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups. See disclaimer
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