**Conflict of interest**

leading to regurgitant backflow of blood into the left atrium during the course of each cardiac circle which over time leads to an enlarged left atrium and ventricle causing heart failure.

Myxoma [Latin Greek word "muxa" for mucus] means a myxoid tumor of primitive connective tissue, a primary tumor affecting adult hearts commonly in the left atrium but can, however, be found in other locations. LAM inflammatory process gives rise to a rapid sequence of chordal thickening and retraction, commissural fusion and finally thickened leaflets [incomplete opening and closure of the leaflets] with an enlarged annulus which eventually leads to regurgitation. Though an uncommon relation to the underlying processes involved with LAM throughout its development until therapy, pathologist has confirmed postoperatively the pathological component of LAM to be a spindle tumor with mucus production histologically made up of fusiform, stellate, and or polygonal cells [42–45] and histologically associ-

This type of regurgitation caused by LAM is rear as compared to other underlying resultant pathological cause and may even be described by some physicians, surgeons, and interventionist as idiopathic due to its ambiguity. The vegetations formed involves series of the pathological process which is activated as a result of incomplete resection of the LAM in combination with natural human oral streptococcal inhabitants [Streptococcus sanguinis and/ or dysgalactiae] which gets into the bloodstream when opportunities present themselves such as during surgeries and colonize the heart valves especially the mitral valve. The result at first is noninfective, but as the collection of platelets, fibrin, microcolonies of microorganisms, and the scant inflammatory cells increases, it shifts to a subacute stage and finally to full-blown endocarditis due to bacterial accumulations as they lodge and aggregate at the site of the

Being the most common primary cardiac neoplasm in adults, the present state of research on its set cause, Pathobiology, physiopathology, and pathophysiology are still elusive as clinical and research efforts are being channeled toward its morbidity, mortality and its possible reoccurrence after surgery. If resultant mitral regurgitations and long-term survival for patients is to be achieved as it's the main goal in all neoplastic diseases, a proper understanding of myxomas pathology and the probable underlying process that could occur before and after therapeutic and/or surgical interventions employed is highly essential to tackle the un resolving issue in the field. Management of this condition requires adequate therapeutical background knowledge of the various possible outcomes to allow for an early identification of masked regurgitations caused by the LAM as a result of the probably altered valve motion or damaged valve apparatus in combination with the activated underlying processes

**5.7. Rheumatic heart disease**

48 Structural Insufficiency Anomalies in Cardiac Valves

ated with interleukin-6 [46].

incomplete LAM resection [1, 47].

**6. Conclusion and future directions**

**5.8. Endocarditis**

The authors declare no conflict of interest.
