Title

Atrial myxoma: a 14 year experience

Document Type

Article

Department

Cardiothoracic Surgery; Anaesthesia

Abstract

Introduction: Cardiac tumors constitute only 0.2% of all tumors. Primary cardiac tumors occur infrequently with an incidence of 0.0017% to 0.19%, estimated on autopsies performed in non-selected populations. Left atrial myxomas are the most prevalent (75% to 80%) and right atrial are less common (10% to 18%). Surgical excision yields an excellent prognosis and recurrence rate of only 3% with a very low morbidity and mortality.
Objective: We aimed to review our experiences with this rare entity and highlight the various aspects of myxoma presentation, diagnosis and outcomes. Methodology: A retrospective chart review done on patients who underwent excision of myxoma with histopathological confirmation from January 1991 till December 2015. Standard surgical approach adopted was single atrial, and augmented with bi-atrial approach, where needed.
Results: A total of 42 cases were identified and 28 cases with complete data were included in the analysis. Mean age was 54.4 ± 17.7 years, with female predominance (58% vs. 42%). Preoperative comorbidities included hypertension (39.2%), diabetes (28.5%), IHD, dyslipidemia, and COPD (10.7%) that were comparable among gender. The mean dimension of myxoma measured on echocardiography was 4.9×3.5×2.7 cm. Sixty four percent had left sided and 35.7% had right sided myxoma. Most common symptom was dyspnea (71%), constitutional symptoms (39.3%) and stroke in (18%). Echo being the diagnostic modality of choice. Post-operative complications occurred in 6 patients and mortality occurred in 2 (7.2%). Mean post-operative follow up was 8.3 months and 10 years telephonic follow up completed in (32%) cases, with 2 late non-cardiac mortalities.
Conclusion: Our results showed that the prevalence of cardiac myxoma is comparable with global estimates. Female gender was predominant and age and right atrial myxoma was slightly higher in our sample compare to other published literature. Myxoma can be excised successfully with a low rate of morbidity, mortality and recurrence.

Publication

Anaesthesia, Pain and Intensive Care