title: No association between herpes simplex virus 1 and cardiac myxoma.
abstract: BACKGROUND
  Cardiac myxoma is the most commonly diagnosed cardiac tumour. Infection of herpes simplex virus 1 (HSV1) has been postulated to be a factor for this pathologic entity. The aim of the current study was to evaluate the association between HSV 1 and myxoma occurrence.
  
  
  METHODS
  Between 1965 and 2005, 70 patients (36 female, mean age: 52.6 years) underwent a resection of myxoma. Selected variables such as hospital mortality and morbidity were studied. A follow-up (FU; mean FU time: 138 ± 83 months) was obtained (76% complete). Immunohistological studies with monoclonal antibodies against HSV type 1 were performed on tumour biopsies of 40 patients.
  
  
  RESULTS
  The mean age was 53 ± 16 years (range 23 to 84 years, 51% female). Of the investigated population, 31 (44%) were in New York Heart Association (NYHA) class III-IV. Mitral valve stenosis was identified in 14 patients (20%), and in 25 (36%) patients mitral valve was insufficient. During hospitalisation 3 patients suffered from a transient neurological disorder, and in addition to myxoma resection 18 (25.7%) patients had to undergo an additional intervention. The overall survival rate was 91% at 40 years. There was no early postoperative mortality in follow-up, although 4 patients died and 2 patients had been re-operated on for recurrent myxomas after 2 and 9 years. Immunohistology revealed no positive signals for HSV-1 antigens among the 40 analysed cases.
  
  
  CONCLUSIONS
  Complete surgical resection, septum included, was the treatment of choice and mandatory to prevent relapse. Peri-operative morbidity and mortality over 40 years remained low, and no association between HSV infection and occurrence of cardiac myxoma was found.
authors.affiliation: Department of Cardiac Surgery, Triemli Hospital, Zürich, Switzerland. Ulrich.Schurr@triemli.stzh.ch
authors.forename: Ulrich P
authors.initials: UP
authors.lastname: Schurr
authors.forename: Denis A
authors.initials: DA
authors.lastname: Berdajs
authors.forename: Beate
authors.initials: B
authors.lastname: Bode
authors.forename: Omer
authors.initials: O
authors.lastname: Dzemali
authors.forename: Maximilian Y
authors.initials: MY
authors.lastname: Emmert
authors.forename: Michele
authors.initials: M
authors.lastname: Genoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006338:Heart Neoplasms / Q000473:pathology / Q000601:surgery / Q000821:virology*; D006566:Herpesviridae Infections / Q000150:complications*; D018259:Herpesvirus 1, Human; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000473:pathology / Q000601:surgery / Q000821:virology*; D009364:Neoplasm Recurrence, Local; D055815:Young Adult