Cardiac Myxoma: Fourteen-Year Experience of a Tertiary Reference Center

Abstract

Introduction: Myxoma is the most common primary cardiac tumor, which is frequently diagnosed between the ages of 30-60 years. Myxomas are encountered more frequently in women. They are mostly located in the left atrium. In this retrospective study, we observed demographic, clinical, pathological, and echocardiographic findings of myxomas. In addition to short and long term follow-up result of patients having myxoma, we researched the risk factors of patients who presented with embolism as a complication of myxoma. Also we researched the risk factors of the patients who represented with embolism.

Patients and Methods: In this retrospective study, we searched the database of our hospital using the keyword “myxoma” between March 2001 and January 2015. Sixty-six patients, whose cardiac tumors were resected and confirmed as myxoma after pathologic evaluation, were included in this study.

Results: The mean age of our surgically treated patients was 55 ± 12.3 years. Forty (% 60.6) of them were female, and the most common presented symptom was dyspnea. An embolic event was noted in %19.7 of patients. Myxomas were mostly located in the left atrium. A total of 4 (%6) patients showed tumor recurrence, and only one patient died during the follow-up. As the patients were compared regarding embolic phenomenon, male gender, location at the roof of the left atrium, and irregular surface characteristics were more frequently associated with embolism.

Conclusion: Contrary to previous studies, in our study, thromboembolic events as an important complication of myxomas was associated with male gender and location at the roof of the left atrium. However, in accordance with other studies, type 1 myxomas were significantly more prevalent in our patients with the diagnosis of embolism.

Keywords

• Myxoma,embolism,echocardiography

Kardiyak Miksoma: Tersiyer Bir Referans Merkezinin 14 Yıllık Deneyimi

Abstract

Giriş: Miksomalar sıklıkla 30 ile 60 yaş aralığında tanı alan en sık görülen primer kardiyak tümörlerdir. Miksomalar kadınlarda daha sık görülür. En sık olarak sol atriyum yerleşimlidirler. Biz retrospektif tek merkezli bu çalışmamızda miksomaların demografik, klinik, patolojik ve ekokardiyografik özellikler ile birlikte kısa ve uzun dönem sonuçlarını sunduk. Ayrıca emboli kliniği ile başvuran miksoma hastalarındaki risk faktörlerini araştırdık.

Hastalar ve Yöntem: Retrospektif tanımlayıcı nitelikteki bu araştırmada üçüncü basamak eğitim ve araştırma hastanemizin veritabanında cerrahi epikrizleri Mart 2001-Ocak 2015 tarih aralığında ‘‘miksoma’’ anahtar kelimesi ile tarandı. Cerrahi olarak rezeke edilmiş ve patolojik olarak kesin tanısı konmuş olan 66 hasta çalışmamıza dahil edildi.

Bulgular: Miksoma tanısıyla elektif cerrahi uygulanan hastalarımızın ortalama yaşları 55 ± 12.3 yıl idi. Kırk (%60.6) hasta kadın cinsiyetindeydi. En sık görülen semptom dispneydi. Hastaların %19.7’sinde geçirilmiş bir emboli atağı mevcuttu. Miksomalar en sık sol atriyumdan köken almaktaydı. Takip süresince 4 (%6) hastada nüks, sadece bir hastada ölüm görüldü. Emboli geçiren ve geçirmeyen gruplar kıyaslandığında emboli geçiren grupta erkek cinsiyet, sol atriyum çatısında yerleşim ve irregüler yüzey istatistiksel anlamlı olarak daha fazla saptandı.

Sonuç: Bizim çalışmamızda, miksomaların önemli bir komplikasyonu olan embolik olaylar, önceki çalışmalardan farklı olarak erkek cinsiyet ve sol atriyum çatısından köken alan miksomalar ile ilişkili bulunmuştur.  Tip 1 miksomalar da diğer çalışmalar ile benzer şekilde emboli tanısı olan hastalarımızda anlamlı derecede daha fazla saptanmıştır.

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