ABSTRACT
Background:Myxomas are the most common primary cardiac tumors that develop mostly at the atrial chambers of the heart and represent 0,25% of all cardiac diseases. Methods: This is a retrospective study aiming to analyze epidemiological and intraoperative data from cardiac myxoma cases in the hospital of the last 32 years. The study population was 145 cardiac surgical patients and was divided into 4 certain 8?year periods. 87,6% of cases had the myxoma located at left atrium and 97,2% of all patients fully recovered. 4,1% of patients relapsed and underwent a redo operation. Results: Mean CPB time and mean ICU length of stay increased during the 8?year periods (p < 0,001, P < 0,001, P = 0,002 and P = 0,003 respectively). In-hospital length of stay decreased to 5 days in the most recent period (p < 0,001). Cases significantly increased to 54 in the last 8?year period (p = 0,009). Conclusion: Improvement on cardiac imaging and a better accessibility may drive patients to earlier and safer diagnosis of myxomas preventing any deterioration of their condition. Improvement on postoperative care can also reduce in-hospital length of stay. Surgical excision is the treatment of choice and guaranteed survival at 97,2% of patients.
ABSTRACT
The purpose of this study is to compare the perioperative total prostate specific antigen [tPSA] levels among coronary artery bypass grafting [CABG] patients with and without extracorporeal circulation [ECC], to investigate the changes overtime of tPSA in each group separately and to determine the effect of body core temperature on tPSA levels.A prospective study was conducted. Our sample was allocated to: [a] Seven patients who underwent off pump CABG [Group I] and [b] 16 CABG patients with ECC [Group II]. The levels of tPSA were measured preoperatively [baseline], intra-operatively and at the 4[th] postoperative day. We compared the two groups on their tPSA levels and we investigated the changes of tPSA overtime in each group separately. Intra-operative serum samples were obtained in significantly lower body temperature in patients of Group II than in those of Group I [31°C vs. 36.9°C, P < 0.001]. In each group separately, postoperative tPSA levels were increased significantly compared to the baseline values [2.55 ng/ml vs. 0.39 ng/ml for Group I, P= 0.005 and 4.36 ng/ml vs. 0.77 for Group II, P < 0.001]. CABG patients with ECC had significantly lower intra-operative tPSA levels than the baseline values [0.67 ng/ml vs. 0.77 ng/ml, P = 0.008]. We did not observe significant differences of tPSA levels between the two groups.CABG surgery affects similarly the perioperative tPSA independently the involvement of ECC. Although all patients had significantly higher early postoperative tPSA levels, only those who underwent CABG with ECC had exceeded normal values and significantly decreased intra-operative tPSA. Hypothermia seems to be the causal factor of tPSA reduction