Cardiac myxoma Mansoura experience, results of 17 cases

ABSTRACT

The study was conducted to evaluate our surgical results and operative outcome after complete excision of cardiac myxoma. This retrospective study was conducted in the Department of Cardiothoracic Surgery, Mansoura University Hospital from march 1996 to January 2007, the study involved 17 patients with intracardiac myxoma for whom excision was done. All patients were subjected to full history taking, clinical examination, routine laboratory and EGG examination. Echocardiography was performed preoperatively, prior to discharge and after a mean duration of 8.47 +/- 2.72 months postoperatively. Seventeen patients of cardiac myxoma were surgically treated. The mean patient age was 37.82 +/- 9.4 years and there was 9 [52.9%] male patients and 8 [47.1%] female patients. The most common preoperative symptom was dyspnea occurring in 7 [41.2%] patients. The mean interval from the onset of symptoms to surgery was 8.29 +/- 4.98 months. The tumor was in the left atrium in 15 [88.3%] patients, in the right atrium in one [5.9%] patient and bilateral myxoma was present in one [5.9%] patient. The heart was approached via median sternotomy in all cases, left atriotomy was done in 15 [88.2%] patients, right atriotomy in one [5.9%] patient while bilateral approach was used in one [5.9%] patient. The tumour was excised completely in all cases and the defective area was repaired directly in 11 [64.7%] cases, and with pericardial patch in 6 [35.3%] cases. The mean cardiopulmonary bypass and aortic cross clamp times were 38.3 +/- 2.36 and 26.4 +/- 2.1 minutes respectively. There was one [5.9%] case hospital mortality due to fatal arrhythmia and 2 [11.8%] cases morbidity in the form of pneumonia and superficial wound infection. All patients underwent echocardiography prior to discharge and at a mean follow up period of 8.47 +/- 2.72 months postoperatively. All survival 16 [94.1%] patients showed no evidence of tumour recurrence clinically or on echocardiographic examination, also ECG abnormalities that were present before surgery had disappeared. In conclusion, in our study there was no recurrence of myxoma after complete excision so surgical excision in considered to be the curative method for treatment of cardiac myxoma that quickly relieves symptoms and must be done early after diagnosis