Sonali Sachdeva1, Rupak Desai2, Sofia Shamim3, Zainab Gandhi4, Ashish Shrivastava5, Divyank Patel6, Muhammad Uzair Lodhi7, Jilmil Raina8, Vikram Itare8, Ahmed Mahmood7, Rajesh Sachdeva2, Gautam Kumar2,9. 1. Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, MA, USA. 2. Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, USA. 3. Internal Medicine, AIM Medical Center, Snellville, GA, USA. 4. Department of Medicine, C.U. Shah Medical College, Surendranagar, Gujarat, India. 5. Department of Pediatrics, Children's Hospital of Michigan/Detroit Medical Center, Detroit, MI, USA. 6. Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA. 7. Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, ID, USA. 8. Department of Internal Medicine, Brookdale University Hospital and Medical Center, New York, NY, USA. 9. Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
Abstract
BACKGROUND: Aortic valve myxoma is the rarest location of the most common primary tumour of cardiac origin. Because of the paucity of data, there is little known about their clinical presentation, diagnosis and complications. METHODS: PUBMED, EMBASE, SCOPUS and WEB OF SCIENCE were systematically searched to identify all published cases of aortic valve myxoma through October 2020. Descriptive statistics were used to report the data. RESULTS: Aortic valve myxomas were more prevalent in young (mean age 41 years) male (75%) patients. It most commonly involved the right coronary cusp (50%). Cerebrovascular events (25%), dyspnoea (18.8%), and distal embolisation (18.8%) were found to be the most frequent complications. Echocardiography remains the diagnostic modality of choice in all cases, histopathology is used for confirmation. Most cases were treated with surgical excision (94%); concomitant aortic valve repair and mechanical aortic valve replacement were performed in 25% and 37.5% cases respectively. Sudden cardiac death was noted in one patient. CONCLUSION: Aortic valve myxomas are more often than not discovered in the context of embolic phenomenon or dyspnoea. The most feared complication is stroke, although mortality remains low in surgically managed cases.
BACKGROUND:Aortic valve myxoma is the rarest location of the most common primary tumour of cardiac origin. Because of the paucity of data, there is little known about their clinical presentation, diagnosis and complications. METHODS: PUBMED, EMBASE, SCOPUS and WEB OF SCIENCE were systematically searched to identify all published cases of aortic valve myxoma through October 2020. Descriptive statistics were used to report the data. RESULTS: Aortic valve myxomas were more prevalent in young (mean age 41 years) male (75%) patients. It most commonly involved the right coronary cusp (50%). Cerebrovascular events (25%), dyspnoea (18.8%), and distal embolisation (18.8%) were found to be the most frequent complications. Echocardiography remains the diagnostic modality of choice in all cases, histopathology is used for confirmation. Most cases were treated with surgical excision (94%); concomitant aortic valve repair and mechanical aortic valve replacement were performed in 25% and 37.5% cases respectively. Sudden cardiac death was noted in one patient. CONCLUSION: Aortic valve myxomas are more often than not discovered in the context of embolic phenomenon or dyspnoea. The most feared complication is stroke, although mortality remains low in surgically managed cases.