Clinical analysis of cardiac myxoma leading to embolic events_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GE Yao ,  SHEN Chunjian , GAO Shun , LIU Chao , NAN Yang , QU Sheng , FU Jiayu , WU Wenzhe , LU Xiaonan

The Department of Thoracic and Cardiovascular Surgery, The Second Hospital Affiliated to Medicine School of Shengyang, Shengyang, 110034, P.R.China;

Corresponding?author：

SHEN Chunjian, Email: shenchunjian1976@hotmil.com

Keywords：

Cardiac myxoma; embolization; clinical features

DOI：

10.7507/1007-4848.201808021

Video：

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Objective To investigate the clinical manifestations of patients with cardiac myxoma and the factors affecting the occurrence of embolic events. Methods A retrospective study of 38 patients with cardiac myxoma diagnosed and surgically removed from January 2010 to December 2017 was performed. There were 11 males and 27 females at age of 32-75 (50.00±16.12) years. The patients were divided into a non-embolized group and an embolized group. The clinical manifestations of the patients were summarized and the factors leading to embolism were analyzed. Rseults Of the 26 patients in the non-embolized group, 22 patients (84.62%) had dyspnea, 14 patients (53.85%) had palpitations, 4 patients (15.38%) had angina pectoris, and 1 patient (3.85%) had heart failure. Of the 12 patients in the embolized group, 4 patients (33.33%) had dyspnea, 3 patients (25%) had palpitations, and 1 patient (8.33%) had angina pectoris. The mean diameter of the non-embolized group was 5.71±1.63 cm, and the maximum diameter of the tumor in the embolized group was 4.52±1.88 cm. There was no significant difference between the maximum diameter of the tumor in the embolized group and the maximum diameter of the non-embolized group (P>0.05). Atrial fibrillation occurred in 2 patients in the non-embolized group before operation. Atrial fibrillation occurred in 5 patients in the embolized group. Atrial fibrillation was more likely to occur in the embolized group (P<0.05). Conclusion Atrial fibrillation in the patients with cardiac myxoma is closely related to embolic events. The size of myxoma is not related to the occurrence of embolic events.

Citation： GE Yao, SHEN Chunjian, GAO Shun, LIU Chao, NAN Yang, QU Sheng, FU Jiayu, WU Wenzhe, LU Xiaonan. Clinical analysis of cardiac myxoma leading to embolic events. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(6): 565-568. doi: 10.7507/1007-4848.201808021 Copy

1.	唐穎. 心臟粘液瘤的發生、特征和分子生物學機制. 中國循環雜志, 2017, 32(7): 719-720.
2.	Orlandi A, Ciucci A, Ferlosio A, et al. Cardiac myxoma cells exhibit embryonic endocardial stem cell features. J Pathol, 2006, 209(2): 231-239.
3.	王棟, 施苗, 張宇, 等. 左房粘液瘤所致后循環多發腦栓塞 1 例報告. 中風與神經疾病雜志, 2017, 34(6): 557-558.
4.	Pucci A, Mattioli C, Matteucci M, et al. Cell differentiation in cardiac myxomas: confocal microscopy and gene expression analysis after laser capture microdissection. Heart Vessels, 2018, 33(11): 1403-1410.
5.	Kayan?i?ek H, Khalil E, Keskin G, et al. Ten years’clinical experience of cardiac myxoma: diagnosis, treatment, and clinical outcomes. Anatol J Cardiol, 2018, 19(2): 157-158.
6.	Zhang M, Ding L, Liu Y, et al. Cardiac myxoma with glandular elements: a clinicopathological and immunohistochemical study of five new cases with an emphasis on differential diagnosis. Pathol Res Pract, 2014, 210(1): 55-58.
7.	Lee SJ, Kim JH, Na CY, et al. Eleven years’experience with Korean cardiac myxoma patients: focus on embolic complications. Cerebrovasc Dis, 2012, 33(5): 471-479.
8.	陳德助, 王建峰, 趙小平. 心臟黏液瘤致栓塞性腦血管病臨床分析. 中華腫瘤防治雜志, 2015, 22(11): 43-44.
9.	Nehaj F, Sokol J, Mokan M, et al. Outcomes of patients with newly diagnosed cardiac myxoma: a retrospective multicentric study. Biomed Res Int, 2018, 2018: 8320793.
10.	曹樹剛, 徐文安, 翟明鋒, 等. 以腦栓塞為首發癥狀的左房粘液瘤 2 例報告. 臨床神經病學雜志, 2014, 27(5): 397-398.
11.	王秀芹, 武小玲. 彩色多普勒超聲診斷心臟粘液瘤的臨床價值研究. 國際醫藥衛生導報, 2016, 22(1): 102-105.
12.	Lee HP, Cho WC, Kim JB, et al. Surgical Outcomes of cardiac myxoma: right minithoracotomy approach versus median sternotomy approach. Korean J Thorac Cardiovasc Surg, 2016, 49(5): 356-360.
13.	石磊. 國內全胸腔鏡與傳統開胸心臟手術的系統評價. 南昌大學醫學院, 2013.
14.	賀清, 俞世強, 徐學增, 等. 完全胸腔鏡與正中開胸治療心臟粘液瘤的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 22(12): 1142-1145.
15.	Dong NG, Zhang KL, Wu L, et al. Right anterolateral minithoracotomy versus median sternotomy approach for resection of left atrial myxoma. Thorac Cardiovasc Surg, 2018, 66(2): 193-197.

1. 唐穎. 心臟粘液瘤的發生、特征和分子生物學機制. 中國循環雜志, 2017, 32(7): 719-720.
2. Orlandi A, Ciucci A, Ferlosio A, et al. Cardiac myxoma cells exhibit embryonic endocardial stem cell features. J Pathol, 2006, 209(2): 231-239.
3. 王棟, 施苗, 張宇, 等. 左房粘液瘤所致后循環多發腦栓塞 1 例報告. 中風與神經疾病雜志, 2017, 34(6): 557-558.
4. Pucci A, Mattioli C, Matteucci M, et al. Cell differentiation in cardiac myxomas: confocal microscopy and gene expression analysis after laser capture microdissection. Heart Vessels, 2018, 33(11): 1403-1410.
5. Kayan?i?ek H, Khalil E, Keskin G, et al. Ten years’clinical experience of cardiac myxoma: diagnosis, treatment, and clinical outcomes. Anatol J Cardiol, 2018, 19(2): 157-158.
6. Zhang M, Ding L, Liu Y, et al. Cardiac myxoma with glandular elements: a clinicopathological and immunohistochemical study of five new cases with an emphasis on differential diagnosis. Pathol Res Pract, 2014, 210(1): 55-58.
7. Lee SJ, Kim JH, Na CY, et al. Eleven years’experience with Korean cardiac myxoma patients: focus on embolic complications. Cerebrovasc Dis, 2012, 33(5): 471-479.
8. 陳德助, 王建峰, 趙小平. 心臟黏液瘤致栓塞性腦血管病臨床分析. 中華腫瘤防治雜志, 2015, 22(11): 43-44.
9. Nehaj F, Sokol J, Mokan M, et al. Outcomes of patients with newly diagnosed cardiac myxoma: a retrospective multicentric study. Biomed Res Int, 2018, 2018: 8320793.
10. 曹樹剛, 徐文安, 翟明鋒, 等. 以腦栓塞為首發癥狀的左房粘液瘤 2 例報告. 臨床神經病學雜志, 2014, 27(5): 397-398.
11. 王秀芹, 武小玲. 彩色多普勒超聲診斷心臟粘液瘤的臨床價值研究. 國際醫藥衛生導報, 2016, 22(1): 102-105.
12. Lee HP, Cho WC, Kim JB, et al. Surgical Outcomes of cardiac myxoma: right minithoracotomy approach versus median sternotomy approach. Korean J Thorac Cardiovasc Surg, 2016, 49(5): 356-360.
13. 石磊. 國內全胸腔鏡與傳統開胸心臟手術的系統評價. 南昌大學醫學院, 2013.
14. 賀清, 俞世強, 徐學增, 等. 完全胸腔鏡與正中開胸治療心臟粘液瘤的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 22(12): 1142-1145.
15. Dong NG, Zhang KL, Wu L, et al. Right anterolateral minithoracotomy versus median sternotomy approach for resection of left atrial myxoma. Thorac Cardiovasc Surg, 2018, 66(2): 193-197.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of cardiac myxoma leading to embolic events

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