Key result
Partial myxoma excision links to local recurrence, while multiple original tumors associate with distant relapse.
Why the study?
Recurrent cardiac myxoma occurs in two distinct patient groups with different surgical implications, but detailed characterization and optimal surgical approaches remain unclear.
Does the initial presentation (single vs multiple myxomas) and surgical excision technique affect the risk and location of recurrent cardiac myxoma?
Observational (n=41)
Does the initial presentation (single vs multiple myxomas) and surgical excision technique affect the risk and location of recurrent cardiac myxoma?
Single cardiac myxomas should be removed by full-thickness excision to prevent local recurrence, while younger patients with multiple myxomas require radical surgery due to the risk of distant recurrence.
Recurrence confined to multiple myxomas at presentation; leaves open whether surveillance intensity should differ by index presentation.
15 consecutive cases where patients (11 female, 4 male) had undergone surgical excision of cardiac myxoma were reviewed. The 11 survivors were re-assessed by trans-oesophageal echocardiography and recurrent myxoma was detected in 2 patients. These two were the only patients who had originally presented with multiple myxomas. Analysis of these cases in conjunction with 26 previously reported cases of recurrence identifies two distinct groups of patients. In one group (12 cases, mean age 48.7 years) recurrence occurred at the site of previous excision, typically following the removal of a single septal myxoma by partial thickness excision. In the second group, which includes our two cases, (16 cases, mean age 30.6 years) recurrent myxoma was found distant to the site of previous excision, typically in younger patients who had multiple myxomas at original operation. These results suggest that 1) single myxomas should be removed by full thickness excision 2) in younger patients with multiple myxomas surgery should be as radical as possible.
No takes yet. Share an insight, caveat, or question.
Waller et al. (1989) conducted an observational in Cardiac myxoma (n=41). Surgical excision of cardiac myxoma was evaluated on Recurrent myxoma. Recurrent cardiac myxoma occurs either locally in older patients (mean age 48.7) after partial excision, or distantly in younger patients (mean age 30.6) with multiple original myxomas.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: