Three years follow-up after cryoablation of a right atrial myxoma arising from the Koch’s triangle
Wauthy et al. Journal of Cardiothoracic Surgery
Three years follow-up after cryoablation of a right atrial myxoma arising from the Koch's triangle
P. Wauthy 0 3
D. Mircev 2
S. Marinakis 1
0 Department of Cardiac Surgery , CHU Brugmann , Université Libre de Bruxelles , Place Van Gehuchten 4, 1020 Brussels , Belgium
1 Department of Cardiac Surgery, Hospital Civil Marie Curie , Chaussée de Bruxelles 140, 6042 Charleroi , Belgium
2 Department of Cardiology, Iris Sud Hospitals , Rue Jean Paquot 63, 1050 Brussels , Belgium
3 Department of Cardiac Surgery , CHU Brugmann , Université Libre de Bruxelles , Place Van Gehuchten 4, 1020 Brussels , Belgium
We reported 3 years ago the use of cryoablation in the treatment of a right atrium myxoma arising from the Koch's triangle. The atrioventricular conduction was successfully preserved. Today, after 3 years follow-up, the patient remains with a conducted sinus rhythm and is free of recurrence. Even if extensive resection of the stack of the myxoma remains the first choice attitude, cryoablation could be considered as a serious second choice alternative.
Myxoma; Cardiac tumors; Koch's triangle; Cryoablation
limited to 1 year. Wang et al.  reported recently
in an important series an overall rate of recurrence
of 5%. Recurrences of cardiac myxomas after
resection have been for a long time mainly attributed to
incomplete resection of the myxoma’s pedicle [4, 5].
Nowadays, even if this consideration remains
relevant, multicentric myxomas growth is considered as
the principal risk factor for recurrence . Shinfeld
et al. analyzed the reported cases of recurrent
myxomas and observed that up to 57% of them were
diagnosed within the first 3 years following initial
treatment . Finally, Gerbode et al. reported that
myxomas recurrence occurs preferably in men than
in women . After all these considerations, we can
reasonably state that this 81 years old women will
not likely present a local recurrence of the initial
myxoma. Though we conclude that even if extensive
stack resection remains the golden standard
attitude, cryoablation may be considered as a valuable
secondary alternative to extensive myxomas stalk
resection when this excision is hazardous.
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Fig. 1 Transthoracic echocardiography demonstrating the absence of recurrence in the right atrium close to the Koch’s triangle
Availability of data and supporting materials
The data of this article are available by request to the authors.
SM and DM have collected the follow-up data of this manuscript. The
corresponding author PW has been involved in drafting the manuscript.
PW, SM and DM have been involved in revising critically the paper. All
the authors have read and approved this final manuscript.
Ethics approval and consent to participate
This study was approved by the “Comité d'éthique hospitalier du Centre
Hospitalier Universitaire Brugmann (OM 026)” with the reference number CE
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