Early surgical outcomes of cardiac myxoma resection according to dominant clinical phenotype in adult patients

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiac myxoma (n=133). Intervention: Cardiac/obstructive dominant clinical presentation vs. Other dominant presentations (embolic, constitutional, asymptomatic). Primary outcome: Post-operative atrial fibrillation (p=0.038).

Q: What does this research mean for the field?

In adult patients undergoing cardiac myxoma resection, dominant clinical presentation does not affect major early post-operative outcomes, but a cardiac/obstructive presentation is associated with higher rates of post-operative atrial fibrillation and longer hospital stays. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Haluk Caglar Karakaya; Levent Ceylan; Rukiye Yilmaz; Mahmut Yargı; Bulend Ketenci

doi:10.14744/nci.2026.20587

September 16, 2026Northern Clinics of IstanbulOpen Access

Early surgical outcomes of cardiac myxoma resection according to dominant clinical phenotype in adult patients

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Key result

Cardiac presentation in myxoma resection is linked to ~25% postoperative AF risk and longer stays.

P=0.038
n=133

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Why the study?

Early surgical outcomes after cardiac myxoma resection according to dominant clinical presentation in adults were not well characterized.

Does the dominant clinical presentation at diagnosis affect early post-operative outcomes in adult patients undergoing cardiac myxoma resection?

Key Points

To evaluate early post-operative outcomes according to dominant clinical presentation at diagnosis in adult patients undergoing cardiac myxoma resection.
Retrospectively analyzed 133 consecutive adult patients who underwent surgical resection of histopathologically confirmed cardiac myxoma between January 2004 and December 2024 at a single center.
Categorized patients into four dominant clinical presentation phenotypes: cardiac/obstructive (47.4%), asymptomatic (18.8%), embolic (18.0%), and constitutional (15.8%).
Compared baseline features, operative variables, and early post-operative outcomes, including 30-day mortality, post-operative atrial fibrillation, stroke, and length of stay across phenotype groups.
Major early adverse outcomes did not differ significantly among phenotype groups, with an overall 30-day mortality of 3.8% and post-operative stroke of 3.8%.
Post-operative atrial fibrillation was significantly more frequent in the cardiac/obstructive group (25.4%) than in the embolic (8.3%), constitutional (4.8%), and asymptomatic groups (8.0%; p=0.038).
Median hospital stay was significantly longer in the cardiac/obstructive group (8 days) compared to the embolic (7 days), constitutional (7 days), and asymptomatic groups (6 days; p=0.043), with intensive care unit stay also differing significantly (p=0.046).

Study Design

Type

Cohort (n=133)

Multicenter

No

Structured PICO

Does the dominant clinical presentation at diagnosis affect early post-operative outcomes in adult patients undergoing cardiac myxoma resection?

P

Population

133 adult patients who underwent surgical resection for histopathologically confirmed cardiac myxoma evaluated for early post-operative outcomes based on dominant clinical presentation.

E

Exposure

Surgical resection of cardiac myxoma (categorized into groups by dominant clinical presentation: asymptomatic, cardiac/obstructive, embolic, and constitutional)

C

Comparator

Comparison among the 4 dominant clinical presentation phenotype groups (embolic n=24, cardiac/obstructive n=63, constitutional n=21, asymptomatic n=25)

O

Outcome

Early post-operative outcomes including 30-day mortality, post-operative atrial fibrillation, post-operative stroke, pulmonary thromboembolism, low cardiac output syndrome, reoperation for bleeding, permanent pacemaker implantation, intensive care unit stay, and hospital stayhard clinical

Main Result

p-value: p=0.038

Cardiac/obstructive presentation in cardiac myxoma is associated with increased post-operative atrial fibrillation and longer hospital stays, but not with increased major early surgical morbidity or mortality compared to other presentations.

Limitations

Retrospective single-center design introduces selection bias and limits generalizability
Limited sample size with small and unbalanced symptom subgroups
Reliance on medical records may not completely eliminate overlap between symptom presentations
Late mortality and recurrence were not evaluated due to incomplete follow-up data
Absence of minimally invasive cases in the cohort
Retrospective single-center design with limited sample size and reliance on medical records
Possible overlap between symptom presentation groups
Small and unbalanced symptom subgroups limiting statistical power
Limited number of early adverse events restricting multivariable adjustment
Lack of late mortality and recurrence follow-up data

Implication

May warrant heightened post-operative AF monitoring in cardiac/obstructive myxoma cases; leaves open whether presentation predicts long-term outcomes.

Abstract

OBJECTIVE: This study aimed to evaluate the early surgical outcomes according to the dominant clinical presentation in adult patients undergoing cardiac myxoma resection. METHODS: A total of 315 patients who underwent cardiac mass resection procedures in a single center were retrospectively analyzed. After the exclusion criteria were applied, 133 consecutive adult patients who underwent surgical resection of histopathologically confirmed cardiac myxoma between January 2004 and December 2024 in a single center. Patients were categorized into four groups according to their dominant clinical presentation at diagnosis: asymptomatic, cardiac/obstructive, embolic, and constitutional. Baseline characteristics, tumor features, operative variables, and early post-operative outcomes were compared among the groups. RESULTS: The median age was 63 years, and 63.9% of patients were female. Cardiac/obstructive symptoms represented the most frequent dominant presentation (47.4%). Major early post-operative outcomes were comparable among groups, whereas post-operative atrial fibrillation (AF) and intensive care unit/hospital stay were significantly higher in the cardiac/obstructive group. CONCLUSION: Dominant clinical presentation was not associated with differences in major early post-operative outcomes following cardiac myxoma resection. Cardiac/obstructive presentation was associated with more post-operative AF and longer recovery.

Discussion

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Cite This Study

Karakaya et al. (2026) conducted a cohort in Cardiac myxoma (n=133). Cardiac/obstructive dominant clinical presentation vs. Other dominant presentations (embolic, constitutional, asymptomatic) was evaluated on Post-operative atrial fibrillation (p=0.038). In adult patients undergoing cardiac myxoma resection, cardiac/obstructive presentation was associated with a higher incidence of post-operative atrial fibrillation (25.4%) and longer hospital stays compared to other presentations, despite similar major early adverse outcomes.

synapsesocial.com/papers/6ad0fd1915427f6a840404b2 https://doi.org/10.14744/nci.2026.20587

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Early surgical outcomes of cardiac myxoma resection according to dominant clinical phenotype in adult patients

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Early surgical outcomes of cardiac myxoma resection according to dominant clinical phenotype in adult patients

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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