title: Cardiac myxoma - clinical presentation and long-term post-operative follow-up.
abstract: BACKGROUND
  Myxoma is the commonest cardiac neoplasm. Due to varying symptomatology, its diagnosis can prove difficult. It is agreed to have an excellent prognosis.
  
  
  OBJECTIVE
  Assessing the clinical course in patients operated on due to cardiac myxoma in two departments of cardiac surgery over the course of a decade.
  
  
  METHODS
  The medical records of patients operated on due to cardiac myxoma between 1999 and 2009 were analysed. The patients were then invited for an ambulatory visit, during which transthoracic and transoesophageal echocardiographic examinations were performed.
  
  
  RESULTS
  There were 61 patients (47 females) with histologically confirmed myxoma operated upon. The commonest symptoms leading to diagnosis were heart failure (16 patients, 26%) and syncope (12 patients, 20%). There were five (8%) in-hospital deaths and two (3%) non-fatal strokes. Follow-up duration ranged between one and ten years (6.1 ± 3.2 years). Nine (15%) deaths occurred during follow-up. In four (7%) patients, myxoma recurred in the original location. Echocardiography performed at follow-up visit revealed one recurrence of myxoma, and minor pathologies in 20 patients. Patients who died perioperatively were significantly older compared to those who survived (69 ± 9.7 years vs 56 ± 13, p = 0.02). Patients who died during the follow-up were also significantly older than those who were alive at the time of the contact visit (65 ± 15 years vs 56 ± 12, p = 0.02). Death during follow-up occurred four times more often in males than females (36% vs 8.5%, p = 0.02). There were more deaths during the follow-up in patients whose initial presenting symptom was dyspnea: five deaths (31%) vs four deaths (9%, p = 0.04). The recurrence of myxoma was significantly more frequent in patients with a shorter duration of symptoms before the operation: 8.6 ± 15 weeks with relapse vs 33.9 ± 40 weeks without relapse (p = 0.04).
  
  
  CONCLUSIONS
  Both, serious and benign events following myxoma excision are common. Clinical and echocardiographic surveillance should be implemented in all patients who undergo a myxoma operation.
authors.affiliation: 3rd Department of Cardiology, Silesian Medical University, Katowice, Poland. ezurek@gmail.com
authors.forename: Ewa
authors.initials: E
authors.lastname: Gaszewska-Żurek
authors.forename: Paweł
authors.initials: P
authors.lastname: Zurek
authors.forename: Mirosław
authors.initials: M
authors.lastname: Wilczyński
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Krzych
authors.forename: Ryszard
authors.initials: R
authors.lastname: Bachowski
authors.forename: Marek
authors.initials: M
authors.lastname: Jasiński
authors.forename: Stanisław
authors.initials: S
authors.lastname: Woś
authors.forename: Andrzej
authors.initials: A
authors.lastname: Bochenek
authors.forename: Michał
authors.initials: M
authors.lastname: Tendera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006338:Heart Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000473:pathology* / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome