Surgical management of cardiac myxomas in elderly patients

Objective: Cardiac myxoma usually presents during early adulthood. There is generally a tendency for prompt surgical resection. However, advanced age of patients presenting with this disease may increase the operative risk due to other cardiac and non-cardiac problems. Therefore, we evaluated elderly patients who underwent surgery for myxoma to review the management of treatment. Methods: Between September 1985 and March 2012, a total of 17 consecutive patients over 65 years of age (5 male, 12 female; mean age: 69.3±3.5 years) who had undergone surgical resection for cardiac myxoma were analyzed retrospectively. Echocardiography had been performed in all patients to diagnose the myxoma and evaluate other cardiac pathologies. Coronary angiography had been performed in all patients except in two cases who underwent emergency surgery. Results: Thirteen patients (76.4%) survived the operation. Two patients who underwent emergency operation died early and four patients died during the follow-up time. Concomitant procedures included coronary artery bypass grafting in two, radiofrequency ablation in one, mitral valve reconstruction in one and femoral embolectomy in one patient. Conclusions: In an era of aging population, myxoma tends to be diagnosed more frequently in elderly and high-risk patients. Complete preoperative assessment of these patients is a more appropriate approach in stable patients than the traditional emergency surgery applied to all cases.