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Research Article
 
DOI:doi:10.11909/j.issn.1671-5411.2019.04.003
Long-term outcome of patients with atrial myxoma after surgical intervention: analysis of 403 cases
Chen-Xi JIANG,Jian-Gang WANG,Rui-Dong QI,Wei WANG,Li-Jian GAO,Jing-Hua ZHAO,Chun-Xiao ZHANG,Meng-Chen ZHOU,Xin TU,Mei-Sheng SHANG,Yan YAO.Long-term outcome of patients with atrial myxoma after surgical intervention: analysis of 403 casesJ Geriatr Cardiol 2019,16(4):338~343
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Authors:Chen-Xi JIANG1;Jian-Gang WANG2;Rui-Dong QI2;Wei WANG3;Li-Jian GAO4;Jing-Hua ZHAO5;Chun-Xiao ZHANG6;Meng-Chen ZHOU7;Xin TU7;Mei-Sheng SHANG8;Yan YAO8

Author Affiliation:1.Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;2.Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;3.Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;4.Center for Coronary Heart Disease, Department of Cardiology, Cardiovascular Institute & Fuwai Hospital, CAMS & PUMC, National Center for Heart Disease, Beijing, China;5.Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;6.Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;7.College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China;8.Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;

Foundation:

Abstract: Objective To assess long-term survival and late cardiovascular events in patients with atrial myxoma after surgical intervention. Methods Retrospective analysis of 403 patients undergoing resection of atrial myxoma from January 2002 to December 2016 was con-ducted with a median follow-up period of 4.5 (range: 0.5-15) years. Results The cross-clamp time and cardiopulmonary bypass times were 41.1 ± 21.4 and 65.2 ± 27.3 min, respectively. A diagnosis of myxoma was histopathologically confirmed in all cases. The early in-hospital mortality rate was 0.7% (n = 3). During the follow-up period, tumor recurrence occurred in six patients and cerebral infarction in nine. There were 48 (11.9%) patients with late onset atrial fibrillation (AF). By multivariate analysis, age (HR = 1.05, 95% CI: 1.02–1.09, P < 0.001), left atrial diameter (HR = 1.23, 95% CI: 1.08–1.36, P = 0.012), and mitral valve surgery (HR = 1.17, 95% CI: 1.05–1.29, P = 0.027) were independent predictors of late onset AF. Twenty-one (5.2%) patients died during the follow-up period. Advanced age (HR = 1.07, 95% CI: 1.04–1.10, P = 0.003) and multiple surgical procedures (HR = 1.18, 95% CI: 1.06–1.29, P = 0.012) were significantly associated with overall mortality. Conclusions Atrial myxoma can be resected with good long-term survival. Late onset AF is common after surgery in patients with atrial myxoma. Advanced age, left atrial diameter, and mitral valve surgery were independent predictors of outcomes.

Keywords:

Atrial fibrillation; Atrial myxoma; Embolism; Survival
Received:October 05, 2018        Accepted:April 02, 2019   Published Online:April 28, 2019
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