Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Keeling, IM; Oberwalder, P; Anelli-Monti, M; Schuchlenz, H; Demel, U; Tilz, GP; Rehak, P; Rigler, B.
Cardiac myxomas: 24 years of experience in 49 patients.
Eur J Cardiothorac Surg. 2002; 22(6):971-977
Doi: 10.1016%2FS1010-7940%2802%2900592-4
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- Führende Autor*innen der Med Uni Graz
- Keeling Ingeborg
- Co-Autor*innen der Med Uni Graz
- Anelli-Monti Michael
- Demel Ulrike
- Oberwalder Peter
- Rehak Peter
- Rigler Bruno
- Tilz Gernot
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- Abstract:
- OBJECTIVES: In this single-center study we reviewed our experience with a significant number of cardiac myxoma cases occurring over the past two decades. PATIENTS AND METHODS: Cardiac myxomas represented 86% of all surgically treated cardiac tumors at our center. Specifically, there were 49 consecutive patients, each with at least one myxoma. A detailed clinical, immunological, and echocardiographic long-term examination of 37 patients revealed one recurrent myxoma. RESULTS: Most myxomas originated from the left atrium (87.7%), but also much less frequently from the mitral valve (6.1%), from the right atrium (4.1%), and from the left and right atria (2.0%). The myxomas produced a prolapse into the left ventricle in 40.8% of the patients, mitral stenosis in 10.2%, and threatened left ventricular outflow tract obstruction in 2.0%. Multiple myxomas were found in 20.4% of the patients. Cardiac signs appeared in 93.9% of the patients. Preoperative embolic events had occurred in 26.5%. Immunologic alterations were present in 87.5%. For resection, a bilateral atriotomy was used. An additional aortotomy was needed to expose one mitral valve myxoma. Postoperatively, 81.1% of the patients remained without cardiac symptoms. The early mortality rate was 2.0% and the late mortality rate was 6.1%. Long-term prognosis was excellent with an actuarial survival rate of 0.74. Specific immunologic alterations were found in 71.4% of the patients. The actuarial freedom from reoperation of the myxoma was 0.96. The rate of reoperations was low with 2.0% after 24 years. CONCLUSIONS: Myxomas were usually detected and operated on in symptomatic patients. A high index of suspicion seems important for early diagnosis. Immunologic findings may play an additional role in confirming the diagnosis and the recurrence of a myxoma. Immediate surgical treatment was indicated because of the high risk of embolization or of sudden cardiac death. Also, a familial genesis must be excluded in myxoma patients.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Cardiac Surgical Procedures - methods
- Female - methods
- Follow-Up Studies - methods
- Heart Atria - methods
- Heart Neoplasms - diagnosis
- Humans - diagnosis
- Male - diagnosis
- Middle Aged - diagnosis
- Myxoma - diagnosis
- Neoplasm Circulating Cells - diagnosis
- Postoperative Complications - diagnosis
- Prognosis - diagnosis
- Risk Factors - diagnosis
- Survival Rate - diagnosis
- Treatment Outcome - diagnosis
- Find related publications in this database (Keywords)
- cardiac myxoma
- immunology
- cardiac surgery