Volodymyr IsaienkoM.M. Amosov National Institute of Cardio-Vascular surgery of the Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
Title: Features of diagnosis and surgical treatment of myxomas of the heart
Introduction: Among heart tumors, myxomas make up about 80% of benign neoplasms. In cardiosurgical practice, the frequency of diagnosis of primary heart tumors (PHT), of which more than 80% are morphologically benign tumors, ranges from 0.09% to 1.9% of the total number of hospitalized patients.
The aim of the study: To determine the issue of optimal diagnostic tactics and surgical treatment with heart mix.
Material and methods: In the N.M. Amosov National Institute of Cardio-Vascular surgery of the Academy of Medical Sciences of Ukraine for the period from January 1, 1969 to January 1, 2023, 1015 patients were operated on for primary heart tumors. Cardiac myxomas (CM) were found in 902 (88.9%) patients, of which 793 (87.9%) cases were myxomas of the left atrium (LA). Myxomas of the right atrium (RA) were determined in 81 (9.0%) observations, CM in the left (LV) and right (RV) ventricles - in 8 (0.9%) cases, respectively. Multicentric tumor growth with damage to two or three chambers of the heart was detected - in 12 (1.3%) patients. The age of CM patients ranged from 3 to 79 years (on average 48.4 ± 3.4 years), of which 653 (72.4%) were aged 31 to 60 years. Non-myxoma benign tumors were observed in 41 (4%) cases. Malignant tumors were observed in 70 (6.9%) cases.
Results: 328 (36.3%) and 77 (8.5%) patients with CM were assigned to III and IV functional classes according to the NYHA classification, respectively, which often required urgent surgical treatment in these groups. Hospital mortality in recent years was 0% in the surgical treatment of CM, that is, 539 operations were performed without fatal consequences.
Conclusions: The issues of optimal tactics for patients with CM consist of urgent diagnosis and surgical intervention, which ensures the effectiveness of treatment of CM, which is confirmed by the data of long-term results. There were 684 (78.3%) patients in in I functional class NYHA, in II functional class - 129 (14.8%) patients, respectively; patient survival up to 20 years was 79.7%.