Long-term outcome of patients with atrial myxoma after surgical intervention: analysis of 403 cases

Detection, Prevention, and Treatment of Asymptomatic Myxoma in a Young Adult Patient: A Case Report

We present a case of myxoma originating from the right ventricular outflow tract. The patient was referred to our clinic after detecting a heart murmur at a routine school medical check-up, which is unique to Japan. He was treated with tumor resection and cryoablation to prevent recurrence. Cryoablation after tumor removal has the potential to prevent the recurrence of cardiac tumors. This case further emphasized the importance of regular school medical check-ups because it prevented sudden death.

Thirty-five years of single-center experience in cardiac myxoma surgery and related postoperative complications

Introduction

Myxoma is the most common benign primary cardiac tumor.

Aim

To present a single center's 35-year experience with myxoma surgery in terms of surgical technique and postoperative complications.

Material and methods

The data of 166 patients (56.7 ±12.6 years old, 68.1% female) with surgically removed myxoma were retrospectively analyzed. Information on blood transfusions, additional procedures and postoperative complications was collected.

Results

A median sternotomy was performed in 97.5% of patients. A right mini-thoracotomy was performed in 4 patients. Most (95.2%) patients were semi-urgent. The reason for truly urgent surgery was hemodynamic instability in 4.8% of patients. Crystalloid cardioplegia was used in 62% of cases. Postoperative complications were observed in 12% of patients. One death was observed on the first postoperative day. During hospitalization, 6 deaths (3.6%) were observed. The most common cause of death was multisystemic organ failure. There were no gender differences in mortality and complications.

Conclusions

Surgical treatment of myxomas is a relatively safe procedure with a mortality rate comparable to other types of cardiac surgery. The postoperative complication rate is low. Gender has no influence on the complication rate or type.

Risk factors assessment and a Bayesian network model for predicting ischemic stroke in patients with cardiac myxoma

Objective

This study aims to identify relevant risk factors, assess the interactions between variables, and establish a predictive model for ischemic stroke (IS) in patients with cardiac myxoma (CM) using the Bayesian network (BN) approach.

Methods

Data of patients with CM were collected from three tertiary comprehensive hospitals in Beijing from January 2002 to January 2022. Age, sex, medical history, and information related to CM were extracted from the electronic medical record system. The BN model was constructed using the tabu search algorithm, and the conditional probability of each node was calculated using the maximum likelihood estimation method. The probability of each node of the network and the interrelationship between IS and its related factors were qualitatively and quantitatively analyzed. A receiver operating characteristic (ROC) curve was also plotted. Sensitivity, specificity, and area under the curve (AUC) values were calculated and compared between the BN and logistic regression models to evaluate the efficiency of the predictive model.

Results

A total of 416 patients with CM were enrolled in this study, including 61 with and 355 without IS. The BN model found that cardiac symptoms, systemic embolic symptoms, platelet counts, and tumor with high mobility were directly associated with the occurrence of IS in patients with CM. The BN model for predicting CM-IS achieved higher scores on AUC {0.706 [95% confidence interval (CI), 0.639-0.773]} vs. [0.697 (95% CI, 0.629-0.766)] and sensitivity (99.44% vs. 98.87%), but lower scores on accuracies (85.82% vs. 86.06%) and specificity (6.56% vs. 11.48%) than the logistic regression model.

Conclusion

Cardiac symptoms, systemic embolic symptoms, platelet counts, and tumor with high mobility are candidate predictors of IS in patients with CM. The BN model was superior or at least non-inferior to the traditional logistic regression model, and hence is potentially useful for early IS detection, diagnosis, and prevention in clinical practice.

Cardiac myxoma shedding leads to lower extremity arterial embolism: A case report

BACKGROUND

Left cardiac myxoma (CM) is the most common benign tumor of primary cardiac tumors, but because of its special position caused by pathological physiology change, caused by the complications of the heavier, the surface is often accompanied by blood clots, once fall out, it causes peripheral vascular embolization, such as acute lower limb artery embolization, harmfulness is large, high morbidity, and easy to occur repeatedly.

CASE SUMMARY

A 67-year-old male patient suddenly appeared numbness and weakness of the left lower limb and could not walk without obvious incentive. The patient was finally diagnosed as left CM complicated with acute lower limb arterial embolism after completing cardiac ultrasound, computer tomography angiography, and histopathological analysis, such as hematoxylin-eosin stain staining, immunohistochemistry and special staining including alcian blue staining and periodic acid schiff staining. Arterial thrombosis was removed successfully by femoral artery thrombectomy, postoperative numbness and weakness of the patient's left lower limb disappeared, skin temperature became warm, and dorsal foot artery pulsation was accessible. The patient was readmitted to the hospital 8 mo after discharge for left atrial mass resection, and was diagnosed as CM by postoperative histopathological examination.

CONCLUSION

Although CM is rare, it may be considered as the source of embolism in patients with acute limb ischemia. Repeated loss of thrombus on the tumor and its surface may lead to repeated embolism of peripheral vessels. Cardiac ultrasound is helpful for early diagnosis. Here, we use this case report to highlight left CM as an important cause of acute limb ischemia and to report our experience in the diagnosis and treatment of lower limb arterial embolism caused by CM detachment.