Clinical presentation and treatment of cardiac myxoma in 153 patients

Abstract

Cardiac myxoma (CM) is the most common benign cardiac tumor. We retrospectively reviewed our single center experience in 153 patients with CM over a period 25 years.From November 1993 to May 2017, 153 patients were operated in our institution with diagnosis of a CM. In all patients preoperative, perioperative, and postoperative data were recorded including the long-term follow-up. All patients followed up in the outpatient's clinics and echocardiography at regular intervals.Mean age 59 ± 12 years old. There were 104 women and 49 men. Preoperative clinical manifestations of the patients were hemodynamic consequences (47.7%), asymptomatic (46.4%), systemic embolism (4.5%), systemic manifestations-fever (0.7%), and hemoptysis (0.7%). The most common location of CM was in the left atrium in 82.4% patients. Mean tumors diameter was 4.5 ± 1.9 cm. In addition, we were observed that the age of the patients have differences between sex groups women versus men, 60.3 and 54.8 years old respectively (P = .02). On the other hand the tumor size have not differences between the sex groups (P = .56). Combine operations were performed in 24 (15.7%) patients. New cerebrovascular accident was observed in 2 patients post-op. Mean in-hospital stay was 8.02 ± 2.8 days. In-hospital mortality was 1 patient (0.7%) (from sepsis). During median follow-up 3.7 ± 4.3 years CM recurrence was identified in 5 (3.3%) patients.Surgical resection of CMs contributes in an excellent prognosis and associated with low complications and recurrences rate. Regular long-term follow-up is recommended in all patients with CM.

Rare Cardiac Myxoma with A Hard Texture: A Case Report

“…About 70% of patients with cardiac myxoma show symptoms of intracardiac obstruction, such as left and right sided heart failure, with dyspnoea, syncoptic episodes, arrhythmia, palpitations, congestive heart failure, or sudden death [3]. In our case, the patient felt chest stu ness, which may be coerced by dyspnea, a sign of intracardiac obstruction.…”

“…They are three times more common in females and 90% are diagnosed in the fourth to sixth decades of one's life [2]. Cardiac myxoma can be seen in all chambers of the heart, but arises most commonly in the left atrium (60% -80%), interatrial septum, and fossa ovalis [3]. About 5% of myxoma patients show a familial pattern of tumor development based on autosomal dominant inheritance.…”

Current challenges in the diagnosis and treatment of cardiac myxoma

“…A genetic to 2.5% of patients, in the left ventricle in 0.7% to 3.6% of patients, and in a heart valve (aortic, mitral) in fewer than 1% of patients. 1,4,9,11,13,19,20,24 Most studies reported that CM was identified in the left atrium in about 72% to 92% patients. 2,5,15 The fossa ovalis in the interatrial septum was the most common site to which CM, with or without a broad base, was attached.…”

“…The clinical manifestations of CM are divided into 3 groups: hemodynamic consequences, systemic or pulmonary embolization, and systemic or constitutional manifestations. 1,4,7,10,20 However, approximately 3.2% to 46.4% of patients with CM are asymptomatic. 3,5,11,19,20 The clinical manifestations of patients included in this review are shown in A pedunculated tumor attached to the interatrial septum is the most frequent characteristic of atrial CM (FIGURE 4).…”

“…Computed tomography coronary angiography may be preferred in patients below 40 years of age, also in those at cardiovascular risk, whereas patients older than 40 years, including those at cardiovascular risk, should underwent conventional coronary angiography. 7,11,20 A genetic analysis of patients with familial CM and Carney complex with concomitant CM may detect occult CM. Familial CM is an unusual form of CM, occurring in 5% of patients with CM.…”