Cardiac myxoma: systematic review of the literature on clinical and surgical outcomes

Abstract

Introduction: Cardiac myxoma is one of the most frequent benign primary cardiac tumors in adults and originates predominantly in the atria. Treatment is complete surgical resection, usually via median sternotomy.

Objective: To evaluate the clinical and surgical outcomes of cardiac myxoma resection through a systematic review of the literature.

Methodology: A systematic review of the available literature was conducted for the period 2021-2025, according to PRISMA criteria, on PubMed and SciELO platforms. The keywords were: cardiac myxoma, myxoma, atrial myxoma, left atrial myxoma, valvular myxoma, cardiac surgical procedure, thoracic surgery, cardiac surgery, surgery, heart surgery.

Results: The systematic review included 15 studies published between 2021 and 2025 comprising 1,279 patients according to the count of the included series. Age ranged from 42 to 66 years, with female predominance and most frequent location in the left atrium. Dyspnea, palpitations and embolic events were common presentations. In series that described the approach, median sternotomy predominated; right mini-thoracotomy and robotic resection were also reported in selected groups. One series of 26 patients used right and left atriotomies in 22 cases (84.6%). In a retrospective comparison of 94 patients, robotic surgery was associated with less drainage and shorter postoperative stay, but with longer cardiopulmonary bypass time, aortic cross-clamping and higher hospital cost. Perioperative mortality was low in most series, although heterogeneity of populations precludes causal comparison between approaches.

Conclusion: Surgical resection of cardiac myxoma is a safe, highly effective procedure associated with excellent short- and long-term outcomes.