Clinical presentation of atrial myxomas does it differ in left or right sided tumor?

OBJECTIVE

This paper reports a 20 years' experience in the management of atrial myxomas at our institution. Apart from presenting our experience of their clinical presentation, surgical management, post-operative complication, and long-term follow-up we investigated any correlation between left and right sided tumor with their symptom of presentation.

MATERIALS AND METHODS

The data were retrospectively collected for patients between the period 1995 and 2015 from the hospital database. The follow-up was conducted by questionnaire received from the patients describing their current status.

RESULTS

Fifty four consecutive patients underwent surgical resection for atrial myxomas. The mean age was 62 years (standard deviation [SD]: ±14 years) with a larger number of female (55.5%) patients. The most common location for the tumor was the left atrium (70.3%) with the atrial septum being the most common (63%) site of attachment. The tumors presented in a variety of ways, namely, as shortness of breath (37.03%), transient ischemic attack (24.07%), and chest pains (22.2%) being the more common modes of presentation. Left heart tumors presented 6 years earlier with more severe shortness of breath as compared to right-sided tumors. Post-operative atrial fibrillation occurred in 22.2% of patients. Concomitant surgical procedures were required in 26% of patient. The median length of post-operative hospital stay was 6 days (IQR: 5; 9). There were 2 (3.7%) in-hospital mortalities and 4 (7.4%) later deaths at 2, 3, 7, and 15 years, respectively. Long-term follow-up actuarial Kaplan-Meire survival for the whole group was 92.6 ± 3.6% at 20 years with a significant reduction in the severity of shortness of breath.

CONCLUSION

Cardiac myxoma is the most common form of the cardiac tumor with a slight female preponderance. Left-sided tumors present earlier than right-sided tumors with more severe shortness of breath. Excellent long-term results can be achieved with surgical intervention for cardiac myxomas, including any concomitant interventions. In particular, a sustained reduction in shortness of breath is observed.