Operative Experience and Clinical Outcomes in Cardiac Myxoma Patients: A Retrospective Single-Center Study

Background  Cardiac myxoma is the second most common primary cardiac tumor; however, contemporary single-center series integrating operative strategy with clinical outcomes remain limited.

Objectives  To describe the operative approaches and clinical outcomes of patients undergoing surgical resection of cardiac myxomas at a single center.

Methods  We conducted a retrospective review of 74 consecutive patients who underwent surgical resection of histologically confirmed cardiac myxomas between 2014 and 2024 at a tertiary referral center in Brazil. Clinical, imaging, surgical, and follow-up data were collected. The primary outcome was the incidence of thromboembolic events. A significance level of 5% was adopted for all statistical analyses.

Results  The median age was 60 years (range 52-66), and 68.9% of patients were female. Median follow-up was 60 months (interquartile range 40-79). Thromboembolic events occurred in 14 patients (18.9%), including stroke (13.5%), embolic myocardial infarction (2.7%), and pulmonary embolism (2.7%). In multivariable Cox analysis, diabetes was independently associated with a lower hazard of thromboembolic events (HR 0.11; 95% CI 0.006-0.740; p < 0.05), whereas postoperative atrial fibrillation was associated with a higher thromboembolic risk (HR 6.74; 95% CI 1.490-30.510; p < 0.05). Tumor recurrence occurred in 2.7% of cases. Only one death was recorded during follow-up.

Conclusion  Cardiac myxomas are associated with significant thromboembolic and hemodynamic risks. Early surgical resection provides excellent long-term outcomes and should be considered even in asymptomatic patients. In our cohort, tumor morphology showed a non-significant trend toward a higher risk of thromboembolic events.

Keywords:
Mixoma; Doenças Cardiovasculares; Surgery; Latin America

•Cardiac myxomas are the second most common primary cardiac tumors, and surgical resection remains the treatment of choice.

•In this single-center study of 74 patients, operative outcomes were excellent, with a low recurrence rate (2.7%) and high long-term survival (98.6%).

•Thromboembolic events occurred in 18.9% of patients, with diabetes associated with a lower hazard of these events.

•These findings support the safety and long-term effectiveness of surgical resection for cardiac myxomas, even with conservative use of interatrial patch reconstruction.

Central Illustration:
Operative Experience and Clinical Outcomes in Cardiac Myxoma Patients: A Retrospective Single-Center Study