Surgical Treatment of Cardiac Myxomas: A 23-Case Experience
Objective: Although seen rarely compared to all tumors, cardiac tumors are tumors which may have a mortal course with possible complications. The most common cardiac tumor in adults is myxoma with its benign character. The results of cardiac tumors resected with open cardiac surgery in our center are reported in this study.
Materials and Methods: Twenty-three cardiac tumor patients electively operated on in our clinic between January 2010 and August 2017 were retrospectively included in the study. Information of the patients participating in the study were registered. The patients were between 25 and 67 years of age, and 18 were female (72.3%), and 5 were male (21.7%). The average age of the patients was 42.1 ± 8.9 years. Echocardiography was used for diagnosis in all patients. There was no common complaint for the patients, with the complaints changing according to tumor location. All patients were operated on by means of cardiopulmonary bypass with aortic cross-clamp and bicaval cannulation. Preoperative demographical characteristics and perioperative and postoperative data were registered for the patients and were evaluated statistically.
Results: Nineteen of the tumors (82.6%) were in the left atrium, and 4 were (17.4%) in the right atrium. Diameter of the tumors changed between 2.5 × 1.5 and 8.5 × 6.5 cm. The tumoral structure was resected together with the solid tissue located in its root in all patients operated on. Pericardial patch was used for 11 (47.8%), and primary closure was used for 12 (51.2%) of the defects. Early and late mortality was not observed in any patient.
Conclusion: To prevent possible complications of cardiac myxomas, they need to be resected together with the surrounding healthy tissue as soon as possible after the diagnosis. Cardiac myxomas can be operated on with a tolerable operation risk. Echocardiography should be made annually for any possible relapse after operation.
Abu Abeeleh M, Saleh S, Alhaddad E, et al. 2017. Cardiac myxoma: clinical characteristics, surgical intervention, intra-operative challenges and outcome. Perfusion 32(8):686-90.
Akyol A, Şimşek H, Yaman M, Gur AK, Akdag S. 2016. A giant atrial myxoma with fairly atypical features. Int J Cardiovasc Acad 2(1):42-3.
Baikoussis NG, Papakonstantinou NA, Dedeilias P, et al. 2015. Cardiac tumors: a retrospective multicenter institutional study. J BUON 20(4):1115-23
Barreiro M, Renilla A, Jimenez JM, et al. 2013. Primary cardiac tumors: 32 years of experience from a Spanish tertiary surgical center. Cardivasc Pathol 22(6):424-7.
Brinjikji W, Morris JM, Brown RD, et al. 2015. Neuroimaging findings in cardiac myxoma patients: a single-center case series of 47 patients. Cerebrovasc Dis 40(1-2):35-44.
Garatti A, Nano G, Canziani A, et al. 2012. Surgical excision of cardiac myxomas: twenty years experience at a single institution. Ann Thorac Surg 93(3):825-31.
Gur AK, Kaya Y, Karakurt A, Güvenç TS. 2012. Miksoma ve fibroelastomanın eşlik ettiği Carney sendromlu hasta. Dicle Med J 39(3):413-15. Turkish.
Haji K, Nasis A. 2017. Radiological characteristics of atrial myxoma in Cardiac Computed Tomography. J Cardiovasc Comput Tomogr 11(3):234-6
He D, Zhang Y, Liang Y, et al. 2015. Risk factors for embolism in cardiac myxoma: a retrospective analysis. Med Sci Monit. 21:1146-54.
Hoffmeier A, Sindermann JR, Scheld HH, Martens S. 2014. Cardiac tumors—diagnosis and surgical treatment. Dtsch Arztebl Int 111(12): 205-11
Ikeda A, Tsukada T, Konishi T, Matsuzaki K, Jikuya T, Hiramatsu Y. 2014. Right atrial myxoma with a large tumor embolus in the left pulmonary artery. J Surg Case Rep. 2014(10):rju115.
Kaplan M, Demirtaş MM, Çimen S, Gerçekoğlu H, Yapıcı F, Özler A. 2002. Kardiyak miksoma: 45 olguluk deneyim. Turkish J Thorac Cardiovasc Surg 10(1):11-14. Turkish.
Pinede L, Duhaut P, Loıre R. 2001. Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases. Medicine (Baltimore) 80(3):159-72.
Rahman SM, Kibria MG, Rahim AM, Hosain N, Quashem MA. 2015. Clinical presentation of left atrial myxoma in relation to anatomic and pathologic type. Cardiovasc J 8(1):19-22.
Shah IK, Dearani JA, Daly RC, et al. 2015. Cardiac myxomas: a 50-year experience with resection and analysis of risk factors for recurrence. Ann Thorac Surg 100(2):495-500.
Siminelakis S, Kakourou A, Batistatou A, et al. 2014. Thirteen years follow-up of heart myxoma operated patients: what is the appropriate surgical technique? J Thorac Dis 6(suppl 1):S32-8.
Ying L, Lin R, Gao Z, Qi J, Zhang Z, Gu W. 2016. Primary cardiac tumors in children: a center’s experience. J Cardiothorac Surg 11(1): 52.
Yu L, Gu T, Shi E. 2016. Echocardiographic findings and clinical correlation with cardiac myxoma. JACC Cardiovasc Imaging 9(5):618-21.
Zheng JJ, Geng XG, Wang HC, Yan Y, Wang HY. 2013. Clinical and histopathological analysis of 66 cases with cardiac myxoma. Asian Pac J Cancer Prev 14(3): 1743-6.
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