Clinical characteristics and long term post-operative outcome of cardiac myxoma

Abstract

Background and aim: Myxoma is the most common type of primary cardiac neoplasm, but the clinical characteristics and long term outcome are less known in the elderly in China.

Methods: We analyzed medical records of 112 consecutive patients who underwent operative resection of cardiac myxoma between December 1988 and December 2010 in our hospital. Their data were retrospectively analyzed and the difference between two age groups (< 60 years, n = 87 and ≥ 60 years, n = 25) was compared.

Results: The mean age of 112 patients was 48.8 ± 12.5 (range 13 ~ 75) years, and 66 patients (58.9 %) were female. The interval from onset of symptoms to diagnosis was 12 months and the most common presenting symptoms were chest distress (66 patients 58.9 %), followed by palpitations (55 patients, 49.1 %) and dyspnea (47 patients, 42.0 %). Mitral valve diastolic murmur was heard in 67 (59.1 %) patients. The tumor was located in the left atrium in 96 (85.8 %) patients. There were no in-hospital death. During follow-up ranged between one and twenty-one (7.3 ± 5.3) years, there was no malignancy. Myxoma recurred in 3 (2.7 %) patients and deaths occurred in 5 (4.5 %) patients. The 5 and 15 years survival was 97.8 % and 89.5 %, respectively. To compare with the younger patients, the elderly have higher ratios of concomitant hypertension, fewer complaints of dyspnea and chest distress (p < 0.05).

Conclusion: The elderly have lower complaints of dyspnea and chest distress, surgical treatment is associated with low long-term mortality and recurrence rate even in the elder patients.

Keywords: cardiac myxoma; clinical characteristics; outcome; the elderly.

Table 1. Clinical characteristics of myxomas

Table 2. Location and volume of tumor

Table 3. Concominant surgical procedures

Table 4. Surgical results

Table 5. Logistic analysis of variable by mortality

Table 6. Logistic analysis of variable by clinical embolism

Figure 1. Based on the Cox regression, the proportion of patients surviving 5 and 15 years were 97.8 % and 89.5 %, respectively. All 112 patients completed the follow-up without censored cases.