Outcomes of Surgery for Cardiac Myxoma with Cerebral Embolism

Objectives: Cardiac myxoma (CM) is the most frequent, cardiac benign tumor and is associated with enhanced risk for cerebrovascular events (CVE). Surgery is the only curative treatment to prevent CVE recurrence. We sought to clarify the effect of stroke on clinical outcomes in patients with CM.

Methods: From June 2005 to August 2020, data from 67 consecutive patients with CM who underwent surgical procedures were retrospectively reviewed. Patient records were analyzed for demographics, operative details, postoperative outcome and recurrence. The patients were classified into embolic and nonembolic group. Mortality rate was defined as in death within 30 days.

Result: The average age of the patients was 61.3 ± 12.5 years and 56.72% of patients were female. There were 55 left atrial myxomas (82.09%), 9 right atrial myxomas (13.42%) and 3 left ventricle myxomas (4.48%). Cerebral Embolization was observed in 14 patients (20.9%) before surgery. Tumor recurrence occurred in 2 patients. The early in-hospital mortality rate was 2.99%. Female gender (62.26 vs. 37.71% p = 0.07), size and papillary-type pathology were no significantly different between nonembolic and embolic Group.

Conclusion: Early excision using cardiopulmonary bypass has been established as the only acceptable mode of treatment for these tumors. The surgeon must try to prevent fragmentation and intraoperative embolization. Nevertheless, the postoperative survival is high with a very low rate of complications. The presence of embolization at the time of surgery does not increase perioperative morbidity or mortality.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
19 February 2021