Cardiac myxoma: sixteen-year experience in Central Chest Institute of Thailand.

BACKGROUND

Among the rare diseases of primary cardiac tumor myxoma is a leading pathology. A sixteen-year clinical experience and follow-up ofpatients with surgical removal of this particular mass is reported.

MATERIAL AND METHOD

Medical records of intracardiac tumor patients between April 1995 and June 2012 were reviewed and only cardiac myxoma patients who underwent surgical resection were studied The data of clinical presentations, investigations, operative details, and results were analyzed.

RESULTS

Forty-five cardiac myxoma patients with a mean age of 52.6 +/- 2.3 (14 to 82) years were on operated during the sixteen-year period; of these, 76% were female. Dyspnea was the most common symptom accounting for approximately 78%,followed by heart failure 38%, and stroke 18%. Constitutional symptoms of weight loss, fatigue, and fever were found 33%, 13%, and 11%, respectively. Mean ejection fraction was 62% and the tumor size varied from 1.4 to 10 centimeters in diameter Site distribution of tumors were left atrium (89%), right atrium (9%), and multiple site (2%), with the interatrial septum as the most frequent site of attachment (69%). Patients with irregular surface tumors had 29% greater chance of having stroke than those with smooth surface tumors (p = 0.015). There was no operative or post-operative mortality. The complete follow-up was 98% with 99.8 +/- 52 months of mean follow-up. Ten and fifteen-year survival were 97%. A recurrence was found in one patient with multiple site tumors at eight-year follow-up.

CONCLUSION

Myxoma is a rare disease with a variety of clinical presentation. Surgical resection provides excellent operative and long-term survival. Despite a very insignificant chance of recurrence, long-term follow-up is still necessary.