Cardiac Myxoma: Sixteen-Year Experience in
Central Chest Institute of Thailand
Pramote Porapakkham MD*,
Pornwalee Porapakkham MD**, Promporn Petchyungtong RN*
Affiliation :
* Department of Cardiothoracic Surgery, Central Chest Institute of Thailand, Nonthaburi, Thailand
** Cardiology and Intervention Department, Central Chest Institute of Thailand, Nonthaburi, Thailand
Background : Among the rare diseases of primary cardiac tumor, myxoma is a leading pathology. A sixteen-year clinical
experience and follow-up of patients with surgical removal of this particular mass is reported.
Material and Method: Medical records of intracardiac tumor patients between April 1995 and June 2012 were reviewed
and only cardiac myxoma patients who underwent surgical resection were studied. The data of clinical presentations,
investigations, operative details, and results were analyzed.
Results : Forty-five cardiac myxoma patients with a mean age of 52.6 2.3 (14 to 82) years were on operated during the
sixteen-year period; of these, 76% were female. Dyspnea was the most common symptom accounting for approximately
78%, followed by heart failure 38%, and stroke 18%. Constitutional symptoms of weight loss, fatigue, and fever were found
33%, 13%, and 11%, respectively. Mean ejection fraction was 62% and the tumor size varied from 1.4 to 10 centimeters in
diameter. Site distribution of tumors were left atrium (89%), right atrium (9%), and multiple site (2%), with the interatrial
septum as the most frequent site of attachment (69%). Patients with irregular surface tumors had 29% greater chance of
having stroke than those with smooth surface tumors (p = 0.015). There was no operative or post-operative mortality. The
complete follow-up was 98% with 99.8 52 months of mean follow-up. Ten and fifteen-year survival were 97%. A recurrence
was found in one patient with multiple site tumors at eight-year follow-up.
Conclusion : Myxoma is a rare disease with a variety of clinical presentation. Surgical resection provides excellent operative
and long-term survival. Despite a very insignificant chance of recurrence, long-term follow-up is still necessary.
Keywords : Cardiac myxoma, Clinical presentation, Surgical resection, Outcomes
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