Early and long-term outcome of surgery for cardiac myxoma: experience of a single cardiac surgical centre

Abstract

Background: Outcome after surgery for cardiac myxoma is very good, although due to relatively low prevalence in general population there are only a few reports with long-term follow-up that involved large number of patients.

Aim: To evaluate short- and long-term outcome after myxoma removal in a single cardiac surgical centre.

Methods: The study involved 64 patients (42 women and 22 men) at the age ranging from 21 to 79 (mean 54.1 ± 18.8) years who were treated between 1981-2009 in our institution. All patients were operated on from median sternotomy and cardiopulmonary bypass. Additionally, in 6 (9.4%) patients coronary artery bypass grafting was performed (1 to 3 grafts were implanted) and in other 2 (3.1%) ostium secundum atrial septal defect was closed. Patient survival and complications rate were assessed using the Kaplan-Meier curves. Moreover, functional status at the last follow-up examination was evaluated.

Results: Two patients died in the perioperative period (in-hospital mortality 3.1%) and 4 during follow-up ranging from 5 to 320 months (median 81 months, cumulated follow-up period 5376 patient-months). Four other patients were lost from follow-up. One-year survival probability was 0.95 ± 0.03, 5-year - 0.88 ± 0.04 and 10-year - 0.84 ± 0.06. Estimated 10-year freedom from cardiac complications was 0.72 ± 0.08, hospital readmission 0.80 ± 0.07 and cardiac surgical reintervention 0.96 ± 0.03. None of the patients had tumour recurrence. At the last follow-up examination, 90.7% of patients were in functional NYHA classes I or II.

Conclusions: Surgery for cardiac myxoma is associated with low long-term mortality and morbidity. Functional status following operation improved significantly after surgery.