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.	唐颖. 心脏粘液瘤的发生、特征和分子生物学机制. 中国循环杂志, 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.	王栋, 施苗, 张宇, 等. 左房粘液瘤所致后循环多发脑栓塞 1 例报告. 中风与神经疾病杂志, 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.
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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.	陈德助, 王建峰, 赵小平. 心脏黏液瘤致栓塞性脑血管病临床分析. 中华肿瘤防治杂志, 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.	曹树刚, 徐文安, 翟明锋, 等. 以脑栓塞为首发症状的左房粘液瘤 2 例报告. 临床神经病学杂志, 2014, 27(5): 397-398.
11.	王秀芹, 武小玲. 彩色多普勒超声诊断心脏粘液瘤的临床价值研究. 国际医药卫生导报, 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. 国内全胸腔镜与传统开胸心脏手术的系统评价. 南昌大学医学院, 2013.
14.	贺清, 俞世强, 徐学增, 等. 完全胸腔镜与正中开胸治疗心脏粘液瘤的病例对照研究. 中国胸心血管外科临床杂志, 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. 唐颖. 心脏粘液瘤的发生、特征和分子生物学机制. 中国循环杂志, 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. 王栋, 施苗, 张宇, 等. 左房粘液瘤所致后循环多发脑栓塞 1 例报告. 中风与神经疾病杂志, 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. Kayançiçek 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. 陈德助, 王建峰, 赵小平. 心脏黏液瘤致栓塞性脑血管病临床分析. 中华肿瘤防治杂志, 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. 曹树刚, 徐文安, 翟明锋, 等. 以脑栓塞为首发症状的左房粘液瘤 2 例报告. 临床神经病学杂志, 2014, 27(5): 397-398.
11. 王秀芹, 武小玲. 彩色多普勒超声诊断心脏粘液瘤的临床价值研究. 国际医药卫生导报, 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. 国内全胸腔镜与传统开胸心脏手术的系统评价. 南昌大学医学院, 2013.
14. 贺清, 俞世强, 徐学增, 等. 完全胸腔镜与正中开胸治疗心脏粘液瘤的病例对照研究. 中国胸心血管外科临床杂志, 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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