Cor Vasa 2025, 67(Suppl.3):83-88 | DOI: 10.33678/cor.2025.034

Giant Right Ventricle Myxoma Presenting as Right Heart Failure - a Case Report

Štefan Lukačín^a, Tomáš Toporcer^a, Vilém Rohn^b, Pavel Kočan^c, Anton Bereš^a, Marián Homola^a, Michal Trebišovský^a, Adrián Kolesár^a

^a Department of Heart Surgery, Medical Faculty of Pavol Jozef Šafárik University and East Slovak Institute for Cardiovascular Diseases, Košice, Slovakia

^b II. Surgical Clinic - Cardiovascular Surgery, The First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic

^c Department of Pathology, Faculty of Medicine, Pavol Jozef Šafárik University and Louis Pasteur University Hospital, Košice, Slovakia

Introduction: Primary cardiac tumors are generally a very rare condition, with an incidence of only 0.0001% to 0.3% in autopsies. Despite the fact that myxoma is the most common primary heart tumor, fewer than 5% of myxomas, which vary in size, occur in the ventricles.

Case report: A 19-year-old patient with an unremarkable medical history presented with a one-month history of exertional dyspnea, fatigue, facial edema, and palpitations. Echocardiography recorded a mass measur- ing 60 × 70 mm in the right ventricle, spontaneous echo contrast in the right atrium, a maximum blood flow velocity in the pulmonary trunk of 3 m/s, enlargement of right atrium and preserved left ventricle ejection fraction. The patient underwent a resection of the mass with concomitant tricuspid valve replacement with a biological prosthesis under cardiopulmonary bypass. Postoperatively, the condition was complicated by atrioventricular block, and an epicardial electrode and pacemaker were implanted. Histological analysis revealed a cardiac myxoma of diameter 110 × 90 × 50 mm. The follow-up echocardiographic examination three months after surgery documented good function of both the left and right ventricles, with normalization of the right atrial and right ventricle parameters. Discussion and conclusion: Right-sided cardiac tumors can lead to right ventricular outflow tract obstruction, with symptoms of right-sided heart failure. Despite good perioperative outcomes and a low risk of recurrence, early differential diagnosis and early surgical intervention are critical for patients to have an optimistic prognosis.

Keywords: Heart surgery, Right heart failure, Right ventricle myxoma, Right ventricle outflow tract obstruction, Tricuspid valve replacement

Received: January 22, 2025; Revised: January 22, 2025; Accepted: March 3, 2025; Prepublished online: June 2, 2012; Published: September 1, 2025  Show citation