Vol. 28 No. 2 (2024)
CARDIOONCOLOGY

Pre- and postoperative risk factors for hospital complications upon atypically localized left atrial myxomas

T.A. Simonyan
A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russian Federation, Moscow
Bio
L.A. Bockeria
A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russian Federation, Moscow
I.I. Scopin
A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russian Federation, Moscow
I.M. Tsiskaridze
A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russian Federation, Moscow
P.V. Kakhktsyan
A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russian Federation, Moscow
I.Yu. Farulova
A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russian Federation, Moscow
L.V. Spirin
A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russian Federation, Moscow
M.S. Ibragimov
A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russian Federation, Moscow
Central illustration

Published 2024-08-30

Keywords

  • Aged,
  • Embolism,
  • Myxoma,
  • Risk Factors,
  • Retrospective Studies

How to Cite

Simonyan, T., Bockeria, L., Scopin, I., Tsiskaridze, I., Kakhktsyan, P., Farulova, I., Spirin, L., & Ibragimov, M. (2024). Pre- and postoperative risk factors for hospital complications upon atypically localized left atrial myxomas. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 28(2), 30–40. https://doi.org/10.21688/1681-3472-2024-2-30-40

Abstract

Introduction: Cardiac myxoma is the most common of the benign heart tumor. In the left atrium, it is typically located in the interatrial septum in the area of the fossa ovale; any other its localization is considered atypical. The consequences of surgical treatment of typical myxomas have been sufficiently examined; however, there are no data on treatment of atypically localized left atrium myxomas.
Objective: The study is aimed to analyzing the results of surgical intervention upon atypically localized left atrium myxomas and assessing of pre- and postoperative risk factors for adverse hospital events as well as embolic complications.
Methods: A retrospective review of the results upon surgical treatment of atypically localized left atrial myxomas (n = 52) through the period from 2008 to 2022 was performed.
Results: Non-lethal in-hospital complications are revealed in 15 patients (29%). In-hospital mortality is 6% (n = 3). A comparative analysis of transthoracic echocardiography data, collected before surgical intervention and at the time of hospital discharge, demonstrated a decrease in the left ventricular end diastolic volume and in the left atrial dimensions (P < 0.001). Risk factors for non-lethal in-hospital complications are related to the chronic heart failure NYHA 3 (P < 0.01) and EuroSCORE II (P = 0.03). Risk factors for hospital mortality are associated with advanced age (P = 0.03) and EuroSCORE II (P = 0.03). Preoperative embolic complications are attributed to localization of myxoma on the posterior wall of the left atrium (P = 0.02), villous myxoma (P < 0.001), myxoma prolapse into the left ventricle cavity (P = 0.05).
Conclusion: The presented results of surgical treatment of atypically localized left atrium myxomas are comparable to the data of the world literature, including hospital mortality rates (6%). Preoperative risk factors for non-lethal complications are related to chronic heart failure NYHA 3 and EuroSCORE II; for lethal complications they are associated with the age of patients over 65 years and EuroSCORE II. No significant effect of postoperative risk factors on lethal and non-lethal hospital complications was revealed.

Received 3 May 2023. Revised 16 April 2024. Accepted 4 June 2024.

Funding
The study did not have sponsorship.

Conflict of interest
The authors declare no conflict of interest.

Contribution of the authors
Conception and study design: T.A. Simonyan, I.I. Scopin, I.M. Tsiskaridze, P.V. Kakhktsyan
Data collection and analysis: T.A. Simonyan, I.M. Tsiskaridze, I.Yu. Farulova, L.V. Spirin, M.S. Ibragimov
Statistical analysis: T.A. Simonyan, I.M. Tsiskaridze
Drafting the article: T.A. Simonyan, I.M. Tsiskaridze
Critical revision of the article: T.A. Simonyan, L.A. Bockeria, I.I. Scopin, I.M. Tsiskaridze, P.V. Kakhktsyan
Final approval of the version to be published: T.A. Simonyan, L.A. Bockeria, I.I. Scopin, I.M. Tsiskaridze, P.V. Kakhktsyan, I.Yu. Farulova, L.V. Spirin, M.S. Ibragimov

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