Clinical characteristics and postoperative recurrence factors of 1 106 patients with cardiac myxoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOU Mingyang ,  YANG Xiubin , HUA Kun , MAO Bin , ZHANG Liang , SUN Dong , WU Qiang

Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, P. R. China;

Corresponding?author：

YANG Xiubin, Email: az6885@sina.com

Keywords：

Cardiac myxoma; heart surgery; recurrence

DOI：

10.7507/1007-4848.202012118

Video：

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Objective To summarize the clinical characteristics and surgical treatment experience of 1 106 patients with cardiac myxoma. Methods Clinical data of 1 106 patients with cardiac myxoma who underwent surgical treatment in Beijing Anzhen Hospital from 2002 to 2018 were retrospectively analyzed. There were 749 (67.7%) females and 357 (32.3%) males. Results The highest incidence rate was at the age of 51-70 years. The location of the disease was: left atrium in 987 (89.2%) patients, right atrium in 99 (9.0%) patients, left ventricle in 10 (0.9%) patients, right ventricle in 8 (0.7%) patients. There were 1 013 patients of heart classification (NYHA) Ⅰ-Ⅱ and 93 patients of Ⅲ-Ⅳ. There were 301 patients with cerebral infarction and 57 patients with peripheral arterial embolism. Tumor size was closely related to hemodynamic symptoms (P≤0.05), but not to peripheral vascular embolism (P>0.05). Two (0.2%) patients died in hospital and 306 patients were followed up, with a follow-up rate of 27.7%. The median follow-up time was 7 years (range, 1-18 years). One patient died of all causes, and 23 patients recurred, with a recurrence rate of 2.1%. Among 23 recurrent patients, 15 (65.2%) patients were atypical myxoma and 8 (34.8%) patients were typical myxoma. There was no statistical difference in aortic clamping time, ICU stay time, ventilator-assisted breathing time, postoperative hospital stay time, postoperative mortality, or cardiac ejection fraction at discharge between the reoperation in 23 recurrent patients and the first operation in 1 083 non-recurrentpatients. Conclusion Cardiac myxoma is more common in middle-aged and elderly women, and it often occurs in the left atrium. The size of cardiac myxoma can affect the hemodynamic changes. Surgical treatment is effective. Atypical myxoma is more common in recurrent patients, and the effect is still satisfactory through surgical treatment.

Citation： ZHOU Mingyang, YANG Xiubin, HUA Kun, MAO Bin, ZHANG Liang, SUN Dong, WU Qiang. Clinical characteristics and postoperative recurrence factors of 1 106 patients with cardiac myxoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(10): 1337-1341. doi: 10.7507/1007-4848.202012118 Copy

1.	李志剛, 徐志云, 鄒良建, 等. 心臟粘液瘤新的分型探討— 附復發性心臟粘液瘤二例報告及國內文獻復習. 中國胸心血管外科臨床雜志, 2010, 17(1): 13-17.
2.	Mo R, Mi L, Zhou Q, et al. Outcomes of surgical treatment in 115 patients with primary cardiac tumours: A 15-year experience at a single institution. J Thorac Dis, 2017, 9(9): 2935-2941.
3.	Nomoto N, Tani T, Konda T, et al. Primary and metastatic cardiac tumors: Echocardiographic diagnosis, treatment and prognosis in a 15-years single center study. J Cardiothorac Surg, 2017, 12(1): 103.
4.	唐穎. 心臟粘液瘤的發生、特征和分子生物學機制. 中國循環雜志, 2017, 32(7): 719-720.
5.	Tseng IC, Huang WJ, Jhuang YL, et al. Microinsertions in PRKACA cause activation of the protein kinase A pathway in cardiac myxoma. J Pathol, 2017, 242(2): 134-139.
6.	李敏, 郭晨, 呂永會, 等. 常見心臟腫瘤的診療思路. 心血管病學進展, 2019, 40(1): 100-103.
7.	武鴻美, 陳玉, 肖澤斌, 等. 單中心689例心臟腫瘤的臨床病理學分析. 中華病理學雜志, 2019, 48(4): 293-297.
8.	Jain S, Maleszewski JJ, Stephenson CR, et al. Current diagnosis and management of cardiac myxomas. Expert Rev Cardiovasc Ther, 2015, 13(4): 369-375.
9.	Barreiro M, Renilla A, Jimenez JM, et al. Primary cardiac tumors: 32 years of experience from a Spanish tertiary surgical center. Cardiovasc Pathol, 2013, 22(6): 424-427.
10.	Chiariello GA, Bruno P, Colizzi C, et al. Acute heart failure related to a large left atrial myxoma. Proc (Bayl Univ Med Cent), 2018, 31(3): 331-333.
11.	Prifti E, Ademaj F, Kajo E, et al. A giant myxoma originating from the aortic valve causing severe left ventricular tract obstruction: A case report and literature review. World J Surg Oncol, 2015, 13: 151.
12.	Roever L, Casella-Filho A, Dourado PM, et al. Cardiac tumors: A brief commentary. Front Public Health, 2014, 2: 264.
13.	Garatti A, Nano G, Canziani A, et al. Surgical excision of cardiac myxomas: Twenty years experience at a single institution. Ann Thorac Surg, 2012, 93(3): 825-831.
14.	Elbardissi AW, Dearani JA, Daly RC, et al. Survival after resection of primary cardiac tumors: A 48-year experience. Circulation, 2008, 118(14 Suppl): S7-S15.
15.	Acebo E, Val-Bernal JF, Gómez-Román JJ, et al. Clinicopathologic study and DNA analysis of 37 cardiac myxomas: A 28-year experience. Chest, 2003, 123(5): 1379-1385.
16.	Zheng JJ, Geng XG, Wang HC, et al. Clinical and histopathological analysis of 66 cases with cardiac myxoma. Asian Pac J Cancer Prev, 2013, 14(3): 1743-1746.
17.	馬佳, 袁義強, 孟祥光, 等. 心臟黏液瘤臨床診治的進展性研究. 腫瘤基礎與臨床, 2018, 31(1): 91-93.

1. 李志剛, 徐志云, 鄒良建, 等. 心臟粘液瘤新的分型探討— 附復發性心臟粘液瘤二例報告及國內文獻復習. 中國胸心血管外科臨床雜志, 2010, 17(1): 13-17.
2. Mo R, Mi L, Zhou Q, et al. Outcomes of surgical treatment in 115 patients with primary cardiac tumours: A 15-year experience at a single institution. J Thorac Dis, 2017, 9(9): 2935-2941.
3. Nomoto N, Tani T, Konda T, et al. Primary and metastatic cardiac tumors: Echocardiographic diagnosis, treatment and prognosis in a 15-years single center study. J Cardiothorac Surg, 2017, 12(1): 103.
4. 唐穎. 心臟粘液瘤的發生、特征和分子生物學機制. 中國循環雜志, 2017, 32(7): 719-720.
5. Tseng IC, Huang WJ, Jhuang YL, et al. Microinsertions in PRKACA cause activation of the protein kinase A pathway in cardiac myxoma. J Pathol, 2017, 242(2): 134-139.
6. 李敏, 郭晨, 呂永會, 等. 常見心臟腫瘤的診療思路. 心血管病學進展, 2019, 40(1): 100-103.
7. 武鴻美, 陳玉, 肖澤斌, 等. 單中心689例心臟腫瘤的臨床病理學分析. 中華病理學雜志, 2019, 48(4): 293-297.
8. Jain S, Maleszewski JJ, Stephenson CR, et al. Current diagnosis and management of cardiac myxomas. Expert Rev Cardiovasc Ther, 2015, 13(4): 369-375.
9. Barreiro M, Renilla A, Jimenez JM, et al. Primary cardiac tumors: 32 years of experience from a Spanish tertiary surgical center. Cardiovasc Pathol, 2013, 22(6): 424-427.
10. Chiariello GA, Bruno P, Colizzi C, et al. Acute heart failure related to a large left atrial myxoma. Proc (Bayl Univ Med Cent), 2018, 31(3): 331-333.
11. Prifti E, Ademaj F, Kajo E, et al. A giant myxoma originating from the aortic valve causing severe left ventricular tract obstruction: A case report and literature review. World J Surg Oncol, 2015, 13: 151.
12. Roever L, Casella-Filho A, Dourado PM, et al. Cardiac tumors: A brief commentary. Front Public Health, 2014, 2: 264.
13. Garatti A, Nano G, Canziani A, et al. Surgical excision of cardiac myxomas: Twenty years experience at a single institution. Ann Thorac Surg, 2012, 93(3): 825-831.
14. Elbardissi AW, Dearani JA, Daly RC, et al. Survival after resection of primary cardiac tumors: A 48-year experience. Circulation, 2008, 118(14 Suppl): S7-S15.
15. Acebo E, Val-Bernal JF, Gómez-Román JJ, et al. Clinicopathologic study and DNA analysis of 37 cardiac myxomas: A 28-year experience. Chest, 2003, 123(5): 1379-1385.
16. Zheng JJ, Geng XG, Wang HC, et al. Clinical and histopathological analysis of 66 cases with cardiac myxoma. Asian Pac J Cancer Prev, 2013, 14(3): 1743-1746.
17. 馬佳, 袁義強, 孟祥光, 等. 心臟黏液瘤臨床診治的進展性研究. 腫瘤基礎與臨床, 2018, 31(1): 91-93.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical characteristics and postoperative recurrence factors of 1 106 patients with cardiac myxoma

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