ObjectiveWe aimed to present clinical features, surgical approaches, importance of surgical
technique and long-term outcomes of our patients with cardiac myxoma who underwent
surgery.MethodsWe retrospectively collected data of patients with cardiac myxoma who underwent
surgical resection between February 1990 and November 2014. Biatrial approach is the
preferred surgical method in a large proportion of patients that are operated due to
left atrial myxoma because it provides wider exposure than the uniatrial approach. To
prevent recurrence during surgical resection, a large excision is made so as to include
at least 5 mm of normal area from clean tissue around the tumor. Moreover, special
attention is paid to the excision that is made as a whole, without digesting the
fragment of tumor with gentle dissections.ResultsForty-three patients (20 males, mean age of 51.7±8.8 years) were included. Most
common symptom was dyspnea (48.8%). Tumor was located in the left atrium in 37 (86%)
patients. Resections were achieved via biatrial approach in 34 patients, uniatrial
approach in 8 patients, and right atriotomy with right ventriculotomy in 1 patient. One
patient died due to low cardiac output syndrome in the early postoperative period. Mean
follow-up time was 102.3±66.5 months. Actuarial survival rates were 95%, 92% and
78% at five, 10 and 15 years, respectively. Recurrence was observed in none of the
patients during follow-up.ConclusionAlthough myxomas are benign tumors, due to embolic complications and obstructive signs,
they should be treated surgically as soon as possible after diagnosis. To prevent
recurrence, especially in cardiac myxomas which are located in left atrium, preferred
biatrial approach is suggested for wide resection of the tumor and to avoid residual
tumor.
These results indicate that overt hypothyroidism is associated with early impairment in LV longitudinal myocardial function, and that tissue Doppler echocardiography is useful for the grading of disease and detection of early impairment. (ECHOCARDIOGRAPHY 2010;27:505-511).
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