Abstract Body (Do not enter title and authors here): Introduction: Cardiac myxoma is a rare and benign primary cardiac tumor, accounting for 50% of all primary cardiac tumors. The aim of this study is to analyze our experience of cardiac myxomas with a significant number of cases over the past seven years.
Materials and Methods: This is a retrospective and descriptive study of 54 cases of cardiac myxomas, representing 93% of all cardiac tumors surgically treated in our cardiac surgery department, from June 2017 to May 2024. All clinical, morphological, perioperative data and the possibility of recurrence and tumor embolism of these patients were analyzed.
Results: The mean age of the patients was 55 ± 5 years. Women represented 65% (n=35). The circumstances of discovery were dyspnea in 57% (n=31), asymptomatic in 20% (n=11), and embolism in 15% (n=8). Auscultation was normal in 75% (n=46). Complete arrhythmia by atrial fibrillation was observed in 18.5% (n=10). Transthoracic echocardiography revealed the location of the myxoma in the left atrium in 83.3% (n=45), the right atrium in 9.3% (n=5), an exceptional location at the ventricular side of the tricuspid valve in one case, and another rare location in the left ventricle. Myxomas were obstructive in 59% (n=32). Multiple myxomas were found in 4% (n=2). They had a broad implantation base in 85% (n=46). Cardiac CT and/or MRI was used in 28% (n=15). Surgical excision under extracorporeal circulation was performed in all patients, with 18.5% (n=10) considered emergencies and 15% (n=8) performed on a beating heart. Immediate postoperative outcomes were simple in 76% (n=41). There was one death with a mortality rate of 1.8%, and two recurrences were recorded with an actuarial recurrence rate of 0.037 (95% CI: [0.000; 0.087]). The long-term prognosis was excellent with an actuarial survival rate of 0.981 (95% CI: [0.945; 1.000]).
Conclusion: Myxoma is the most common benign cardiac tumor, characterized by clinical polymorphism. Transthoracic echocardiography is the reference examination. Surgery involves a wide excision of the myxoma with its implantation area and should be performed as soon as the diagnosis is confirmed to avoid any embolic complications. The prognosis after surgery is excellent, but follow-up is recommended due to the risk of recurrence.