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

Lin, Yiyun; Xiao, Jian; Chen, Jian; Hong, Jiang; Peng, Hao; Kang, Bo; Wu, Lihui; Wang, Zhinong

Journal of Cardiovascular Medicine: January 2016 - Volume 17 - Issue 1 - p 44–53
doi: 10.2459/JCM.0000000000000114
Cardiac tumors
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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.

aGeneral Hospital of Beijing Military Command, Nanmencang, Beijing

bChangzheng Hospital, Second Military Medical University, Fengyang Road, Shanghai, China

*Yiyun Lin and Jian Xiao contributed equally to this article.

Correspondence to Zhinong Wang, Department of Cardiothoracic Surgery, Changzheng Hospital, Fengyang Road #415, Shanghai 200003, China Tel: +86 021 81885706; fax: +86 021 81885706; e-mail: wangzn007@163.com

Received 18 January, 2013

Revised 26 March, 2014

Accepted 27 March, 2014

© 2016 Italian Federation of Cardiology. All rights reserved.