Treating cardiac myxomas: a 16-year Chinese single-center study

Abstract

Aims: Currently, myxoma is the most common type of primary cardiac tumor diagnosed. This article describes the experience over the past 16 years with cases of cardiac myxoma in Chinese patients and elucidated the differences between solid and papillary myxomas.

Methods: The clinical details of 68 patients with cardiac myxomas who underwent surgery between January 1996 and January 2012 at our center were retrospectively analyzed.

Results: The left atrium was the primary tumor site in 88% of the patients included in this study. The most common implant site was the interatrial septum (69%), especially for patients with solid tumors. Common clinical symptoms included dyspnea and palpitation, whereas embolic events occurred in 12 patients. Myxoma resection involved a midline sternotomy utilizing cardiopulmonary bypass. According to pathological classification, solid myxomas were present in 28 patients (47%), whereas papillary myxomas were detected in 40 patients (53%). In the solid group, arrhythmias and a larger tumor volume were more common. Correspondingly, in 97.4 ± 2.5% of cases, secondary surgery was not needed after 10 years. Overall, the actuarial survival for patients undergoing surgical excision of myxoma was 98.4 ± 1.6% at 5 years and 96.0 ± 2.8% at 10 years.

Conclusion: Solid myxomas were associated with more arrhythmias, a larger tumor volume, implantation in the interatrial septum, and a need for concomitant surgery compared with papillary myxomas. Further studies should determine whether serum or histological markers could be routinely used in combination with echocardiograms, MRI and computed tomography for the predictions of recurrent myxomas during annual follow-up examinations.