What Influences the Patients with Left Atrial Myxoma: From Embolism to Postoperative Atrial Fibrillation
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ORIGINAL SCIENTIFIC REPORT
What Influences the Patients with Left Atrial Myxoma: From Embolism to Postoperative Atrial Fibrillation Sizheng Xiong1 • Lihui Song1 • Gen Li1 • Jun Li1
Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background Preoperative embolism and postoperative atrial fibrillation (POAF) are two important factors associated with impaired health conditions and increased economic burden in patients with left atrial (LA) myxoma. The aim of this study was to analyze embolic events, identify predictors of POAF, and evaluate the risk of late-term survival in patients with LA myxoma. Methods From December 2009 to December 2019, 177 consecutive patients with LA myxoma who met the selection criteria were included in the retrospective analysis. Multivariate logistic regression analysis was performed to identify predictors of POAF. Propensity score matching was used for confounder control, and Cox proportional hazards models were used to evaluate the risk of late-term mortality. Results The study population comprised of 125 patients in non-POAF group and 52 patients in POAF group. Preoperative embolism was present in 27.1% of the all cases. By multivariate analysis, age, NYHA functional class III, LA diameter, and cross-clamp time were identified as independent predictors of in-hospital POAF. The overall survival at 1, 5, and 10 years for the 177 patients was 98.9%, 93.7%, and 84.4%, respectively. There was no statistical difference in late-term survival between the two groups in the Cox proportion-adjusted survival curve. After propensity score 1:1 matching, patients with POAF had a longer postoperative hospital stay and Kaplan–Meier survival curve also showed no statistical difference between the two groups. Conclusions Patients with LA myxoma after surgical treatment had a favorable prognosis. In-hospital POAF was not independently associated with late-term mortality in patients with LA myxoma.
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00268-020-05665-1) contains supplementary material, which is available to authorized users. & Jun Li [email protected] 1
Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, Hankou, Wuhan 430000, China
Cardiac myxomas are the most common benign cardiac tumors in adults. They are rare, and approximately 75% develop in the left atrium [1]. Left atrial (LA) myxoma could be fatal if it causes heart obstruction or systemic embolization [2, 3]. Patients with LA myxoma generally have good overall survival and a relatively low recurrence rate [1, 4, 5], while patients who experience embolic events in the perioperative period have significantly higher morbidity and mortality [6]. Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery, including the resection of LA myxoma, and is
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related to an increased risk of mortality and morbidity
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