What is the clinical evidence from this study?

Study design: Observational. Population: Cardiac myxoma (n=90). Intervention: Surgical resection. Primary outcome: Hospital mortality.

January 1, 2023Open Access

Surgery for cardiac myxomas: 12-year experience

IGIvo GašparovičNational Institute of Cardiovascular Diseases PAPanagiotis ArtemiouNational Institute of Cardiovascular Diseases BBBranislav BezákUniversity of Ostrava

Key Result

Surgical resection of cardiac myxomas resulted in a low hospital mortality of 2.2%, a long-term mortality of 15.6%, and a recurrence rate of 2.7% over a median follow-up of 76 months.

Study Design

Type

Observational (n=90)

Multicenter

Structured PICO

Population

90 patients (mean age 59.4 years, 66.6% female) with cardiac myxomas who underwent surgical resection, followed for a median of 76 months.

Intervention

Surgical resection of cardiac myxoma (90% via median sternotomy, 10% via video-assisted thoracoscopy) with cardiopulmonary bypass.

Outcome

Hospital mortality, long-term all-cause mortality, and recurrence rate at median 76 months follow-up.hard clinical

Surgical excision of cardiac myxomas yields excellent short- and long-term outcomes with a low recurrence rate (2.7%) and low hospital mortality (2.2%).

Limitations

Retrospective study design
Limitations related to long-term follow-up

Abstract

INTRODUCTION: Cardiac myxoma is a rare benign cardiac tumor observed in approximately 0.5-1 case per 1 million people per year. The aim of this study is to review our 12-year experience in the surgical treatment of cardiac myxoma with an emphasis on the clinical, pathologic, diagnostic, and surgical features. METHODS AND PATIENTS: From January 2010 to December 2022, 90 patients (0.67 %) with cardiac myxomas were surgically treated in our institute. Patients´ demographics, cardiac and surgical medical history, surgical procedures, and pre- and post-operative data were analyzed. The median follow-up time was 76 (1-216) months. RESULTS: The mean age of the patients was 59.4 ± 13.5 years, with a higher prevalence of women. The most common preoperative symptoms were arterial embolism and dyspnea, and 35.6 % of patients were asymptomatic. Only 8.9 % of the patients had systemic and constitutional manifestations. The most common location of cardiac myxoma was in the left atrium, followed by the right atrium. Recurrent myxoma developed in 3 patients (2.7 %), and the mean time of recurrence was 55 ± 19.7. Hospital and long-term mortality were 2.2 % and 15.6 %, respectively. CONCLUSION: Cardiac myxoma is the most common heart tumor with a low incidence. Surgical excision yields very good short and long-term outcomes with low recurrence rate after surgery, and remains the treatment of choice (Tab. 4, Fig. 2, Ref. 13). Text in PDF www.elis.sk Keywords: cardiac myxoma, cardiac tumor, recurrence, survival.

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