Benign Cardiac Tumors Research Articles

Resección conservadora del fibroelastoma papilar: resultados y revisión de la literatura

Introduction and objectivesPapillary fibroelastoma is a benign primary cardiac tumor normally located in the valvular endocardium, although it can be found in other endocardial structures. According to recent studies, it could be the most common benign primary cardiac tumor. In a significant number of cases it is asymptomatic, diagnosed incidentally and, in symptomatic cases, usually they present as thromboembolic neurological events. We show our experience in the surgical treatment of papillary fibroelastoma and a review of the literature is performed. MethodsSingle-center retrospective study by reviewing the medical records of all patients diagnosed with papillary fibroelastoma and surgically treated in our department. ResultsFrom January 2016 to October 2022, 14 patients were operated on, predominantly men, with a mean age of 61±12.6 years. The diagnosis was made mostly in almost all cases during the preoperative study for other indications. Most of the tumors were asymptomatic and were located in the aortic valve. No patient required valve replacement or repair. In 5 cases (35.7%) concomitant cryoablation was performed. There was no surgical mortality. After 3.2±2.22 years of follow-up, two patients died of non-cardiac causes. No tumoral recurrences have been found. ConclusionsSurgical treatment of papillary fibroelastoma is safe and offers good short and mid-term results. Concomitant cryoablation might be useful to achieve complete tumor removal without the need for valve replacement, however more evidence is mandatory. The realization of a multicenter registry would allow a better knowledge of this tumors.

Abstract P2178: Trends In Age At Diagnosis, Incidence Proportion Of Benign Cardiac Neoplasms And Associated Outcomes: 2012-2021

Introduction: Incidence of benign cardiac neoplasms (BCNs) and outcomes in large scale studies among adults in US are unknown. We study this using TriNetX database. Methods: We queried TriNetX US Collaborative network housing data from insurance claims and electronic health records. We include adult patients with any ICD code from 01/01/12 - 12/31/21. ICD codes were used to identify BCN and ventricular arrhythmias, ischemic stroke and acute MI after BCN diagnosis. Mortality was identified by patients categorized as deceased after BCN diagnosis. Results: We identified 65.6 million patients (54% female), BCN prevalence was 0.0097% (n=6420). Mean (SD) age at diagnosis for males, females was 58.7 (18.2), 61.1 (17.5) years, respectively. Mean (SD) age at diagnosis increased from 57.2 (20.1) to 62.8 (16.9) years (P < 0.05). Incidence proportion for BCN in females and males was 0.013% and 0.010% respectively, no trend was seen in annual incidence proportion for either sex (P > 0.05). On comparing those with vs without BCN, BCN cases were at higher risk of mortality, Ventricular arrhythmia, Ischemic stroke, and acute MI with RR (95% CI); 3.56 (3.36-3.77), 11.9 (10.9-12.9), 10.09 (9.58-10.62) and 9.41 (8.84-10.02), respectively. The risk of mortality, ventricular arrhythmia, Acute MI and ischemic stroke in males vs females with BCN was 17.4% vs 15.3%, 4.6% vs 4.1%, 7.6% vs 9.2% and 7.5% vs 6.3%, respectively. Conclusion: Annual incidence proportion of BCNs remains stable from 2012-21. An increasing trend in age at BCN diagnosis is seen. Females have higher Incidence proportion and age at diagnosis. BCN patients are at risk of adverse outcomes with males having worse outcomes.

Giant cardiac hemangioma in the right atrium: an asymptomatic surgical case

BackgroundCardiac hemangiomas are rare, accounting for only 5% of benign cardiac tumors. In the past, there have been few reports of giant cardiac hemangiomas that were > 100 mm in size but were asymptomatic.Case presentationA 44-year-old woman presented with a large asymptomatic intracardiac mass that was accidentally detected on echocardiography. The tumor was surgically resected. During surgery, a sharply margined tumor was located in the right atrium; the tumor was histopathologically diagnosed as a cavernous hemangioma. The patient was discharged uneventfully on the 18th postoperative day. No signs of recurrence were observed at 1 year postoperatively.ConclusionsWe report on a surgical case of an asymptomatic giant cardiac hemangioma 115 mm × 92 mm in size, as measured by echocardiography. It is difficult to diagnose cardiac tumors before surgery based on symptoms and imaging. Surgical resection is the most reliable treatment because of its accurate diagnosis and favorable prognosis.

Crosstalk between KIF1C and PRKAR1A in left atrial myxoma

Cardiac myxoma (CM) is the most common benign cardiac tumor, and most CMs are left atrial myxomas (LAMs). Six variations of KIF1C, c.899 A > T, c.772 T > G, c.352 A > T, c.2895 C > T, c.3049 G > A, and c.*442_*443dup in left atrial myxoma tissues are identified by whole-exome sequencing (WES) and Sanger sequencing. RNA-seq and function experiments show the reduction of the expression of KIF1C and PRKAR1A caused by rare variations of KIF1C. KIF1C is observed to be located in the nucleus, bind to the promoter region of PRKAR1A, and regulate its transcription. Reduction of KIF1C decreases PRKAR1A expression and activates the PKA, which causes an increase in ERK1/2 phosphorylation and SRC-mediated STAT3 activation, a reduction of CDH1, TP53, CDKN1A, and BAX, and eventually promotes tumor formation both in vitro and in vivo. The results suggest that inhibition of KIF1C promotes the pathogenesis of LAM through positive feedback formed by the crosstalk between KIF1C and PRKAR1A.

Surgical experience in cardiac myxomas at a tertiary hospital

IntroductionCardiac myxomas account for 50% of all benign cardiac tumors. Their clinical presentation varies from embolisms to fever. Our objective was to describe the surgical experience in the resection of cardiac myxomas during an 8-year period. MethodsThis is a retrospective, descriptive study of a series of cases with cardiac myxomas diagnosed from 2014 to 2022 at a tertiary care center. Descriptive statistics were used to define the populational and surgical characteristics. We used Pearson’s correlation to study the relationship between postoperative complications and age, tumor size and affected cardiac chamber. Results31 patients were included, with a predominance of females (1:2 ratio). The prevalence was 0.44%, which was calculated based on the number of cardiac surgeries performed in our unit over the 8-year period. The main clinical manifestation was dyspnea (85%, n = 23), followed by cerebrovascular event (CVE) (18%, n = 5). Atriotomy and resection of the pedicle were performed with preservation of the interatrial septum. Mortality was 3.2%. The postoperative evolution was uneventful in 77%. Tumor recurrence occurred in 2 patients (7%), both debuting with embolic phenomena. No association was observed between postoperative complications or recurrence and tumor size, nor aortic clamping and extracorporeal circulation times with regard to age. ConclusionsFour atrial myxoma resections are performed in our unit per year, with an estimated prevalence of 0.44%. The tumor characteristics described coincide with the previous literature. A relationship between embolisms and recurrences cannot be ruled out. Wide surgical resection of the pedicle and base of tumor implantation may influence tumor recurrence, although further studies are needed.

Tissue characterization of benign cardiac tumors by cardiac magnetic resonance imaging, a review of core imaging protocol and benign cardiac tumors.

Generally, cardiac masses are initially suspected on routine echocardiography. Cardiac magnetic resonance (CMR) imaging is further performed to differentiate tumors from pseudo-tumors and to characterize the cardiac masses based on their appearance on T1/T2-weighted images, detection of perfusion and demonstration of gadolinium-based contrast agent uptake on early and late gadolinium enhancement images. Further evaluation of cardiac masses by CMR is critical because unnecessary surgery can be avoided by better tissue characterization. Different cardiac tissues have different T1 and T2 relaxation times, principally owing to different internal biochemical environments surrounding the protons. In CMR, the signal intensity from a particular tissue depends on its T1 and T2 relaxation times and its proton density. CMR uses this principle to differentiate between various tissue types by weighting images based on their T1 or T2 relaxation times. Generally, tumor cells are larger, edematous, and have associated inflammatory reactions. Higher free water content of the neoplastic cells and other changes in tissue composition lead to prolonged T1/T2 relaxation times and thus an inherent contrast between tumors and normal tissue exists. Overall, these biochemical changes create an environment where different cardiac masses produce different signal intensity on their T1- weighted and T2- weighted images that help to discriminate between them. In this review article, we have provided a detailed description of the core CMR imaging protocol for evaluation of cardiac masses. We have also discussed the basic features of benign cardiac tumors as well as the role of CMR in evaluation and further tissue characterization of these tumors.

A Ping Pong Ball in the Left Ventricle

Diagnosing cardiac masses, especially those related to cardiac tumors, is often challenging in clinical practice. Though myxomas are the most common and well-known benign cardiac tumors, other rare and often-neglected tumors can be difficult to diagnose. In this case report, the authors describe a left ventricular cardiac mass with unique and striking imaging features.

Long-term outcomes after minimal right lateral thoracotomy for the resection of cardiac tumors

ObjectivesCardiac tumors are a rare and heterogeneous entity, with a cumulative incidence of up to 0.02%. This study aimed to investigate one of the largest patient cohorts for long-term outcomes after minimally-invasive cardiac surgery using right-anterior thoracotomy and femoral cardiopulmonary bypass (CPB) cannulation. MethodsBetween 2009 and 2021, patients who underwent minimally-invasive cardiac tumor removal at our department were included. The diagnosis was confirmed postoperatively by (immune-) histopathological analysis. Preoperative baseline characteristics, intraoperative data, and long-term survival were analyzed. ResultsBetween 2009 and 2021, 183 consecutive patients underwent surgery for a cardiac tumor at our department. Of these, n = 74 (40%) were operated on using a minimally-invasive approach. The majority, n = 73 (98.6%), had a benign cardiac tumor, and 1 (1.4%) had a malignant cardiac tumor. The mean age was 60 ± 14 years, and n = 45 (61%) of patients were female. The largest group of tumors was myxoma (n = 62; 84%). Tumors were predominantly located in the left atrium in 89% (n = 66). CPB-time was 97 ± 36min and aortic cross-clamp time 43 ± 24 min s. The mean hospital stay was 9.7 ± 4.5 days. The perioperative mortality was 0%, and all-cause mortality after ten years was 4.1%. ConclusionMinimally-invasive tumor excision is feasible and safe, predominantly in benign cardiac tumors, even in combination with concurrent procedures. Patients who require cardiac tumor removal should be evaluated for minimally-invasive cardiac surgery at a specialized center, as it is highly effective and associated with good long-term survival.

Diagnosis of the right atrial myxoma after treatment of COVID‐19: A case report

Atrial myxoma is a rare disease but has a broad clinical presentation and complication that involves several systems- heart, lungs, brain, and systemic. An interdisciplinary approach is very important to optimize the outcome in patients with atrial myxomas. A thorough examination by primary care providers is crucial. Then radiologists or cardiologists can help with imaging modalities that can help diagnose and characterize the tumor. Prior to surgical resection by cardiothoracic surgeons, patients need to be evaluated by pulmonologists, cardiologists, and anesthesiologists for preoperative risk stratifications. In patients with neurological complications, pulmonary complications, or infectious endocarditis, input from neurologists, hematologists, infectious disease specialists is essential for patient care. In case antiplatelet/anticoagulation therapy or antibiotic treatment is warranted, pharmacists can provide valuable recommendations. Myxoma is the most common benign cardiac primary tumor, occurring in the right atrium in only 15%-20% of cases. This disease is asymptomatic initially depending upon size of the tumor, and symptoms develop as the tumor spreads. Atrial myxomas are associated with a triad of complications, including obstruction, emboli, and constitutional symptoms (such as fever and weight loss). This regard, embolization of the pulmonary circulation system is a complication of right myxoma. The patient was a 40-year-old male who presented to the emergency department complaining of fever and confusion. He had been previously hospitalized due to COVID-19 and treated with Remdesivir and plasmapheresis. He had tachycardia, tachypnea, thrombocytopenia, and increased liver enzymes. Chest imaging showed nodular lesions with necrotic areas and cavitary lesions in both lungs and the right atrium infected clot was seen in echocardiography. He was treated with intravenous antibiotics and finally underwent heart surgery due to the diagnosis of pulmonary septic embolism. The patient was finally diagnosed with right atrial myxoma according to heart mass histopathology. It is worth noting that the patient's thrombosis had already developed on the right atrial myxoma, which delayed the diagnosis in this patient. This thrombus formation was due to the hypercoagulability state of COVID-19 and following the insertion of a central venous catheter to perform plasmapheresis as a complication of treatment. Special attention should be paid to thromboprophylaxis and the early diagnosis of intravascular and intracardiac thrombosis in COVID-19 patients. Furthermore, the use of imaging modalities is recommended to differentiate thrombus from myxoma.

PAPILLARY FIBROELASTOMA : A CASE REPORT AND REVIEW OF THE LITERATURE

Papillary fibroelastoma (PFEs) is a rare primary benign cardiac tumour which can cause severe embolic complications. We report the case of a 44-year-old with a sessile masse adhering to the aortic valve objectified by a transthoracic echocardiography. This mass was excised surgically and analysed histologically. The diagnosis of papillary fibroelastoma was then confirmed.

Developing a novel positronium biomarker for cardiac myxoma imaging

PurposeCardiac myxoma (CM), the most common cardiac tumor in adults, accounts for 50–75% of benign cardiac tumors. The diagnosis of CM is often elusive, especially in young stroke survivors and transthoracic echocardiography (TTE) is the initial technique for the differential diagnostics of CM. Less invasive cardiac computed tomography (CT) and magnetic resonance imaging (MRI) are not available for the majority of cardiac patients. Here, a robust imaging approach, ortho-Positronium (o-Ps) imaging, is presented to determine cardiac myxoma extracted from patients undergoing urgent cardiac surgery due to unexpected atrial masses. We aimed to assess if the o-Ps atom, produced copiously in intramolecular voids during the PET imaging, serves as a biomarker for CM diagnosing.MethodsSix perioperative CM and normal (adipose) tissue samples from patients, with primary diagnosis confirmed by the histopathology examination, were examined using positron annihilation lifetime spectroscopy (PALS) and micro-CT. Additionally, cell cultures and confocal microscopy techniques were used to picture cell morphology and origin.ResultsWe observed significant shortening in the mean o-Ps lifetime in tumor with compare to normal tissues: an average value of 1.92(02) ns and 2.72(05) ns for CM and the adipose tissue, respectively. Microscopic differences between tumor samples, confirmed in histopathology examination and micro-CT, did not influenced the major positronium imaging results.ConclusionsOur findings, combined with o-Ps lifetime analysis, revealed the novel emerging positronium imaging marker (o-PS) for cardiovascular imaging. This method opens the new perspective to facilitate the quantitative in vivo assessment of intracardiac masses on a molecular (nanoscale) level.

Multiparametric mapping by cardiovascular magnetic resonance imaging in cardiac tumors

BackgroundThere is a paucity of quantitative measurements of cardiac tumors and myocardium using parametric mapping techniques. This study aims to explore quantitative characteristics and diagnostic performance of native T1, T2, and extracellular volume (ECV) values of cardiac tumors and left ventricular (LV) myocardium. MethodsPatients with suspected cardiac tumors who underwent cardiovascular magnetic resonance (CMR) between November 2013 and March 2021 were prospectively enrolled. The diagnoses of primary benign or malignant tumors were based on pathologic findings if available, comprehensive medical history evaluations, imaging, and long-term follow-up data. Patients with pseudo-tumors, cardiac metastasis, primary cardiac diseases, and prior radiotherapy or chemotherapy were excluded. Multiparametric mapping values were measured on both cardiac tumors and the LV myocardium. Statistical analyses were performed using independent-samples t-test, receiver operating characteristic, and Bland–Altman analyses. ResultsA total of 80 patients diagnosed with benign (n = 54), or primary malignant cardiac tumors (n = 26), and 50 age and sex-matched healthy volunteers were included. Intergroup differences in the T1 and T2 values of cardiac tumors were not significant, however, patients with primary malignant cardiac tumors showed significantly higher mean myocardial T1 values (1360 ± 61.4 ms) compared with patients with benign tumors (1259.7 ± 46.2 ms), and normal controls (1206 ± 44.0 ms, all P < 0.05) at 3 T. Patients with primary malignant cardiac tumors also showed significantly higher mean ECV (34.6 ± 5.2%) compared with patients with benign (30.0 ± 2.5%) tumors, and normal controls (27.3 ± 3.0%, all P < 0.05). For the differentiation between primary malignant and benign cardiac tumors, the mean myocardial native T1 value showed the highest efficacy (AUC: 0.919, cutoff value: 1300 ms) compared with mean ECV (AUC: 0.817) and T2 (AUC: 0.619) values. ConclusionNative T1 and T2 of cardiac tumors showed high heterogeneity, while myocardial native T1 values in primary malignant cardiac tumors were elevated compared to patients with benign cardiac tumors, which may serve as a new imaging marker for primary malignant cardiac tumors.

Cardiac hemangioma presenting as a primary cardiac tumor

Cardiac hemangiomas are very rare benign cardiac tumors. They can present at any age and clinical presentation varies according to location and size. We encountered an 87-year-old woman with a left atrial hemangioma clinically diagnosed as cardiac myxoma. Histopathological examination revealed that it was a cavernous-type hemangioma Left atrial hemangiomas, especially those attached to the left atrium wall, may be mistakenly diagnosed as myxomas. Furthermore, a comprehensive review of atrial hemangioma was conducted for the diagnosis and treatment of this uncommon entity.

Left Atrial Myxoma Presented with an Obstructive Shock, Right Ventricle Dysfunction and Pulmonary Hypertension

Myxoma is a benign primary cardiac tumour, mostly located in the left atrial. A 43 years old woman was referred with a difficulty of breathing for 3 months. The patients also complained about weakness, swollen legs, enlarged abdomen, and blood-tinged cough. The patient appeared weak with blood pressure of 80/50 mmHg and grade III/IV systolic and diastolic murmurs were found. Transthoracic echocardiography and pathology evaluation conclude a cardiac myxoma. The patient was diagnosed with a LA myxoma with an obstructive shock, right ventricular (RV) dysfunction and pulmonary hypertension, thus a surgical approach was done immediately to prevent embolism and sudden death. Cardiac features are most likely a consequence of obstructed LV inflow. Transthoracic echocardiography is a useful modality to determine the size, location, and mobility of the mass. The persistence of RV dysfunction post-surgical may be due to the chronicity of the myxoma.

Contrast-enhanced echocardiographic diagnosis of benign and malignant cardiac tumors and its correlation with pathology.

This study aimed to explore the diagnostic value of contrast-enhanced echocardiography (CEE) in benign and malignant cardiac tumors and detect the correlation of CEE parameters and immunohistochemistry (IHC) markers. The data of 44 patients with cardiac tumors confirmed by pathology were reviewed. Lesions were examined before surgery using transthoracic echocardiography (TTE) and CEE with time-intensity curve analysis. The expression of CD31, VEGF and Ki67 was measured by IHC staining. Microvessel density (MVD) was quantified via IHC for CD31. The clinical variables, TTE, CEE and IHC parameters were compared between benign and malignant cardiac tumors. Receiver operating characteristic curve were used to analyze the value of factors in predicting malignant cardiac tumors. The correlation between CEE and IHC parameters was analyzed. Among 44 cardiac tumors, 34 were benign and 10 were malignant. There were significant differences in the TTE parameters (pericardial effusion, tumor boundary, diameter, basal width), CEE parameters (tumor peak intensity (TPI), peak intensity ratio of tumor to myocardium (TPI/MPI), area under time-intensity curve (AUTIC)) and IHC parameters (Ki67, MVD, CD31, VEGF) between the benign and malignant tumor groups (all P < 0.05). Receiver operating characteristic curve analysis showed that the CEE and IHC parameters had diagnostic value in malignant cardiac tumors. There was a correlation between TPI/MPI and Ki67 (r = 0.62), AUTIC and Ki67 (r = 0.50), and AUTIC and CD31 (r = 0.56). TTE and CEE parameters were different between benign and malignant cardiac tumors. CEE is helpful to differentiate the properties of cardiac tumors. There is a correlation between CEE parameters and IHC markers. AUTIC and TPI/MPI can reflect the proliferation and invasion of tumors.

Clinicopathological Correlation of Cardiac Myxoma- Insights from a Large Volume Tertiary Cardiac Center in South India

Background: Cardiac myxomas are the most common benign primary cardiac tumors. They present with a variety of nonspecific cardiac and noncardiac symptoms. Six decades into the first description of the tumor, the explanation of noncardiac symptoms remains an enigma. Literature is sparse to look into the histopathological correlation of the symptoms. Materials and Methods: A prospective study of 47 myxoma patients operated on in our center between August 2016 and December 2018 wherein, their demographic data, electrocardiogram (ECG), echocardiography data, hematological and radiological parameters, and histopathological features were analyzed. Results: Among 47 myxoma patients, 27 were female and 20 were male patients, with an average age of presentation being 48.55 ± 14.01 years for females and 43.81 ± 12.98 for males, P = 0.006. Dyspnea was the most common presenting symptom, seen in 37 (78.4%) patients. Tumor plop was more common among patients with embolization. Ninety-four percent of the myxomas were mobile and solitary, causing significant mitral valve obstruction in 69% of cases and mitral valve regurgitation in 79% of patients. Pulmonary artery hypertension because of myxomas was found in 38% of the patients. The left atrial enlargement was the most common ECG abnormality and was found in 13 (27.7%) patients. Elevated serum C-reactive protein was associated with palpitation whereas neutrophilic infiltration of the tumor was associated with chest pain. Three of the patients recruited were recurrent cases. Infective endocarditis was seen in one patient. Conclusion: Echocardiography gives significant information about the tumors, including the site, mobility, morphology, numbers, and the correlation of symptoms which are due to hemodynamic disturbances caused by the tumor. All the myxomas in our study were solitary in nature and most of them were attached to left interatrial septum at the level of fossa ovalis.

Scope of PET imaging in the evaluation of cardiac tumors

Cardiac and pericardial masses can be categorized as neoplastic (either benign or malignant), non-neoplastic (such as thrombus or pericardial cysts), or normal variants of the cardiac structure. Diagnosing these masses can be challenging, and various imaging modalities are available, with each of them having advantages and pitfalls. Echocardiography is typically the first test used for the evaluation and detection of cardiac masses, as it is widely accessible, portable, and provides a comprehensive assessment of cardiac function and valves without the use of ionizing radiation. However, it may not be helpful in some cases, such as evaluating the extracardiac extension of the mass or characterizing tissue. On the other hand, cross-sectional imaging can provide a three-dimensional data set with excellent spatial resolution. Still, it requires ionizing radiation and intravenous iodinated contrast, and its functional evaluation of the heart may be relatively limited. 18F-FDG PET/CT helps determine 18F-FDG PET/CT is a crucial molecular imaging modality to assess and differentiate benign and malignant cardiac tumors noninvasively and helps in treatment planning and prognostication. Currently, studies evaluating the role of 18F-FDG PET/CT in cardiac tumors are limited to case reports and single center studies.

Non-destructive diagnostic testing of cardiac myxoma by serum confocal Raman microspectroscopy combined with multivariate analysis.

The symptoms of cardiac myxoma (CM) mainly occur when the tumor is growing, and the diagnosis is determined by clinical presentation. Unfortunately, there is no evidence that specific blood tests are useful in CM diagnosis. Raman spectroscopy (RS) has emerged as a promising auxiliary diagnostic tool because of its ability to simultaneously detect multiple molecular features without labelling. The objective of this study was to identify spectral markers for CM, one of the most common benign cardiac tumors with insidious onset and rapid progression. In this study, a preliminary analysis was conducted based on serum Raman spectra to obtain the spectral differences between CM patients (CM group) and healthy control subjects (normal group). Principal component analysis-linear discriminant analysis (PCA-LDA) was constructed to highlight the differences in the distribution of biochemical components among the groups according to the obtained spectral information. Principal component analysis was combined with a support vector machine model (PCA-SVM) based on three different kernel functions (linear, polynomial, and Gaussian radial basis function (RBF)) to resolve spectral variations between all study groups. The results showed that CM patients had lower serum levels of phenylalanine and carotenoid than those in the normal group, and increased levels of fatty acids. The resulting Raman data was used in a multivariate analysis to determine the Raman range that could be used for CM diagnosis. Also, the chemical interpretation of the spectral results obtained is further presented in the discussion section based on the multivariate curve resolution-alternating least squares (MCR-ALS) method. These results suggest that RS can be used as an adjunct and promising tool for CM diagnosis, and that vibrations in the fingerprint region can be used as spectral markers for the disease under study.

Surgery for cardiac myxomas: 12-year experience.

Cardiac myxoma is arare benign cardiac tumor observed in approximately 0.5-1 case per 1 million people per year. The aim of this study is to review our 12-year experience in the surgical treatment of cardiac myxoma with an emphasis on the clinical, pathologic, diagnostic, and surgical features. From January 2010 to December 2022, 90 patients (0.67 %) with cardiac myxomas were surgically treated in our institute. Patients´ demographics, cardiac and surgical medical history, surgical procedures, and pre- and post-operative data were analyzed. The median follow-up time was 76 (1-216) months. The mean age of the patients was 59.4 ± 13.5 years, with a higher prevalence of women. The most common preoperative symptoms were arterial embolism and dyspnea, and 35.6 % of patients were asymptomatic. Only 8.9 % of the patients had systemic and constitutional manifestations. The most common location of cardiac myxoma was in the left atrium, followed by the right atrium. Recurrent myxoma developed in 3 patients (2.7 %), and the mean time of recurrence was 55 ± 19.7. Hospital and long-term mortality were 2.2 % and 15.6 %, respectively. Cardiac myxoma is the most common heart tumor with a low incidence. Surgical excision yields very good short and long-term outcomes with low recurrence rate after surgery, and remains the treatment of choice (Tab. 4, Fig. 2, Ref. 13). Text in PDF www.elis.sk Keywords: cardiac myxoma, cardiac tumor, recurrence, survival.

Miniincisionl versus Median Sternotomy to the Cardiac Myxoma: A Comparison of Outcomes

Cardiac myxoma are the commonest benign cardiac tumor, its pathological character make it higher tendency for showering and embolic complications. Surgery done on urgent base to avoid its complications.