Title : Surgical treatment of myxomas of the heart
Abstract:
Purpose: To determine the possibilities of surgical treatment of myxomas of the heart (MH).
Material and methods: In Institute for period from 1.01.1969 to 1.01.2020 957 patients (pts) with the verified primary tumors of heart were operated . The MH were exposed at 858 (89,6%) patients, from them in 757 (88,1%) cases – MH of the left atrium (LA). The myxomas of right atrium (RA) were determined in 74 (9,5%) supervisions, MH in LV and RV – for 8 (1,0%) cases accordingly. Multicentral growth of MH with a defeat two or three chambers of heart was discovered at 11 (1,3%) patients. Average age of pts with MH were 49,5 ± 3,9 years(3- 78). By III and to the IV functional classes of NYHA classification were taken - 305 (31,8%) and 652 (68,2%) patients accordingly. At macroscopic research MH it was certain that tumors it was been: villiferous – in 502 (58,4%) cases and compact new formations of ovoid or rounded form in 349 (42,3%) accordingly. Concomitant procedures were occured on MVR (n = 15), tricuspid valve`s plasty (n = 4), CABG (n =4). All operations were performed with CPB, moderate hypothermia (32-34 C), antegrade crystalloid cardioplegia.
Results: At surgical treatment of MH hospital mortality was 4,8% (39 cases). In the last 17 years 495 operations were executed without fatal outcomes. Reasons of fatal outcomes it was been: neurological complications – at 16 (46,2%) pts; material embolism - in 12 (30,8%) pts, infarct of myocardium – in 3 (7,7%) pts; septic complication – in 1 (2,6%) pts.In a follow-up period the results of surgical treatment of MH were studied for 698 patients (89,6% written) in terms from 6 months to 47 years (on the average 19,5±4,2 years). Survivability in terms to 20 years was 79,7%. In a follow-up period in I NYHA class were 547 (78,4%) patients, in II l class – 103 (14,8%). Relapses MH discovered for 16 (2,1%) patients in period from 2 to 12 years (on the average 3,5±0,4 years) after operation. All were reoperated.
Conclusion: The adopted tactics ensure the effectiveness of surgical treatment of MH, confirmed by given good follow-up results.
