Mixoma cardiaco: Caracterización clínica, métodos diagnósticos y resultados alejados del tratamiento quirúrgico durante tres décadas de experiencia

Abstract

Background: Cardiac myxoma is the most common primary cardiac tumor. Aim: To evaluate clinical aspects, diagnostic methods and surgical outcomes in patients with cardiac myxoma. Patients and Methods: All patients who underwent surgical resection of a cardiac myxoma between January 1973 and December 2004 at our institution, were identified and their medical records and diagnostic data reviewed. Results: Thirty seven patients identified (24 women), with a median age of 54 years (range 2-74). The most common symptom was dyspnea (51%), followed by embolism (24%) and cardiac murmurs (16%). The diagnosis was made by echocardiogram in 84% of patients. The mean tumor size was 4.9 ± 1.3 cm. The tumor was located in the left atrium in 83% of the patients, right atrium in 8% and left ventricle in 3%. Two patients had multiple tumors. Surgical approach was transeptal in 51%, left atriotomy in 22%, combined transeptal and roof of the left atrium in 19% and right atriotomy in 8%. The tumor and its attachment base were excised in one piece. There were two operative deaths and five late deaths. The mean follow-up was 11.5 years. The 5, 10, 15 and 20 years survival was 89%, 83%, 75% and 64%, respectively. Two patients had recurrence (5.4%), at 2 and 25 years after surgery, respectively, and the recurrence free survival at 10 and 25 years was 97% and 73%, respectively. Conclusions: Dyspnea was the most common symptom and echocardiogram the main diagnostic method. Surgical treatment was highly effective, with low mortality and recurrence rate, with good long term survival.