Arzu ANTAL DÖNMEZ, Ruken Bengi BAKAL, Eylem TUNÇER, Serpil TAŞ, Cevat YAKUT, Nihan KAYALAR, Mehmet Altuğ TUNÇER, Kamil BOYACIOĞLU

Kardiyak miksomalar: 27 yıllık cerrahi deneyim

Amaç: Bu çalışmada merkezimizde yapılan cerrahi kardiyak miksoma rezeksiyonunun sonuçları bildirildi.Çalışmaplanı:Ocak 1985 - Aralık 2012 tarihleri arasında miksoma tanısıyla ameliyat edilen 99 hasta (67 kadın, 32 erkek, ort. yaş 49.8±16 yıl; dağılım 5-76 yıl) retrospektif olarak incelendi. Ameliyat öncesi tanı transtorasik ekokardiyografi ile konuldu. Son takip vizitine kadar geçen ortalama süre 123.4±85.7 ay idi.Bul gu lar: Tüm hastalar median sternotomi ile ameliyat edildi. Tümörün kökeni 92 hastada sol atriyum olup, en sık yerleşim yeri 85 hastada interatriyal septumdu. Bir hasta hariç tüm hastalarda total rezeksiyon yapıldı. Kırk beş hastaya (%45.5) papiller miksoma, 54 hastaya (%54.5) solid miksoma tanısı konuldu. Embolik olay riski papiller tip miksomalarda, solid tipe kıyasla, anlamlı oranda yüksek bulundu (%44.4'e kıyasla %9.3, p

Cardiac myxomas: a 27-year surgical experience

Background: In this study, we reported the outcomes of surgical resection of cardiac myxomas performed in our center. Methods: A retrospective review of 99 patients (67 females, 32 males, mean age 49.8±16 years; range 5 to 76 years) who were operated for myxoma between January 1985 and December 2012 was conducted. Preoperative diagnosis was established by transthoracic echocardiography. The mean time to the last follow-up visit was 123.4±85.7 months. Results: All patients were operated through median sternotomy. The site of origin of the tumor was left atrium in 92 patients and the most common implantion site was interatrial septum in 85 patients. A complete resection of the tumor was performed in all patients except one. Forty five patients (45.5%) were diagnosed with a papillary myxoma, while 54 patients (54.5%) were diagnosed with a solid myxoma. The risk of embolic events in papillary type of myxoma was significantly higher than the solid type (44.4% vs. 9.3%, p

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1. Straus R, Merliss R. Primary tumors of the heart. Arch Pathol 1945;39:74-8.
2. Reynen K. Cardiac myxomas. N Engl J Med 1995;333:1610-7.
3. Yu K, Liu Y, Wang H, Hu S, Long C. Epidemiological and pathological characteristics of cardiac tumors: a clinical study of 242 cases. Interact Cardiovasc Thorac Surg 2007;6:636-9.
4. Roschkov S, Rebeyka D, Mah J, Urquhart G. The dangers of cardiac myxomas. Prog Cardiovasc Nurs 2007;22:27-30.
5. Akbaş H, Kirali K, Dağlar B, Kutay V, Işik O, Yakut C. Surgical treatment of left-atrial myxoma in Carney's complex. Thorac Cardiovasc Surg 1997;45:148-50.
6. Yuan SM. Mitral valve myxoma: clinical features, current diagnostic approaches, and surgical management. Cardiol J 2012;19:105-9.
7. Swartz MF, Lutz CJ, Chandan VS, Landas S, Fink GW. Atrial myxomas: pathologic types, tumor location, and presenting symptoms. J Card Surg 2006;21:435-40.
8. Goodwin JF. The spectrum of cardiac tumors. Am J Cardiol 1968;21:307-14.
9. Zhang T, Zhang X, Zhang X, Jiang J, Chen J, Zhou B. Management of multiple embolization arising from atrial myxoma. Ann Thorac Surg 2012;94:646-9.
10. Kimura K, Iezumi Y, Noma S, Fukuda K. Left to right protrusion of a left atrial myxoma through a patent foramen ovale in a patient with 'cryptogenic' pulmonary embolism. Eur Heart J 2010;31:1247.
11. Garatti A, Nano G, Canziani A, Gagliardotto P, Mossuto E, Frigiola A, et al. Surgical excision of cardiac myxomas: twenty years experience at a single institution. Ann Thorac Surg 2012;93:825-31.
12. Ha JW, Kang WC, Chung N, Chang BC, Rim SJ, Kwon JW, et al. Echocardiographic and morphologic characteristics of left atrial myxoma and their relation to systemic embolism. Am J Cardiol 1999;83:1579-82.
13. Keeling IM, Oberwalder P, Anelli-Monti M, Schuchlenz H, Demel U, Tilz GP, et al. Cardiac myxomas: 24 years of experience in 49 patients. Eur J Cardiothorac Surg 2002;22:971-7.
14. Lad VS, Jain J, Agarwala S, Sinha VK, Khandekar JV, Agrawal NB, et al. Right atrial trans-septal approach for left atrial myxomas--nine-year experience. Heart Lung Circ 2006;15:38-43.
15. Khairnar P, Hsiung MC, Mishra S, Nanda NC, Daly DD Jr, Nayyar G, et al. The ability of live three-dimensional transesophageal echocardiography to evaluate the attachment site of intracardiac tumors. Echocardiography 2011;28:1041-5.
16. Jones DR, Warden HE, Murray GF, Hill RC, Graeber GM, Cruzzavala JL, et al. Biatrial approach to cardiac myxomas: a 30-year clinical experience. Ann Thorac Surg 1995;59:851-5.
17. Patil NP, Dutta N, Satyarthy S, Geelani MA, Kumar Satsangi D, Banerjee A. Cardiac myxomas: experience over one decade. J Card Surg 2011;26:355-9.
18. Bateman TM, Gray RJ, Raymond MJ, Chaux A, Czer LS, Matloff JM. Arrhythmias and conduction disturbances following cardiac operation for the removal of left atrial myxomas. J Thorac Cardiovasc Surg 1983;86:601-7.
19. Centofanti P, Di Rosa E, Deorsola L, Dato GM, Patanè F, La Torre M, et al. Primary cardiac tumors: early and late results of surgical treatment in 91 patients. Ann Thorac Surg 1999;68:1236-41.
20. McCarthy PM, Schaff HV, Winkler HZ, Lieber MM, Carney JA. Deoxyribonucleic acid ploidy pattern of cardiac myxomas. Another predictor of biologically unusual myxomas. J Thorac Cardiovasc Surg 1989;98:1083-6.