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Original article

Vol. 141 No. 3334 (2011)

No association between herpes simplex virus 1 and cardiac myxoma

  • DA Berdajs
  • B Bode
  • O Dzemali
  • MY Emmert
Cite this as:
Swiss Med Wkly. 2011;141:w13223


PRINCIPLES: Cardiac myxoma is the most commonly diagnosed cardiac tumour. Infection of herpes simplex virus 1 (HSV1) has been postulated to be a factor for this pathologic entity. The aim of the current study was to evaluate the association between HSV 1 and myxoma occurrence.

METHODS:Between 1965 and 2005, 70 patients (36 female, mean age: 52.6 years) underwent a resection of myxoma. Selected variables such as hospital mortality and morbidity were studied. A follow-up (FU; mean FU time: 138 ± 83 months) was obtained (76% complete). Immunohistological studies with monoclonal antibodies against HSV type 1 were performed on tumour biopsies of 40 patients.

RESULTS: The mean age was 53 ± 16 years (range 23 to 84 years, 51% female). Of the investigated population, 31 (44%) were in New York Heart Association (NYHA) class III-IV. Mitral valve stenosis was identified in 14 patients (20%), and in 25 (36%) patients mitral valve was insufficient.

During hospitalisation 3 patients suffered from a transient neurological disorder, and in addition to myxoma resection 18 (25.7%) patients had to undergo an additional intervention. The overall survival rate was 91% at 40 years. There was no early postoperative mortality in follow-up, although 4 patients died and 2 patients had been re-operated on for recurrent myxomas after 2 and 9 years. Immunohistology revealed no positive signals for HSV-1 antigens among the 40 analysed cases.

CONCLUSION: Complete surgical resection, septum included, was the treatment of choice and mandatory to prevent relapse. Peri-operative morbidity and mortality over 40 years remained low, and no association between HSV infection and occurrence of cardiac myxoma was found.


  1. Straus R, Merliss R. Primary tumor of the heart. Arch Pathol. 1945;39:74–8.
  2. Prichard RW. Tumors of the heart: review of the subject and report of one hundred and fifty cases. Arch Pathol. 1951;51:98–128.
  3. Chakfe N, Kretz JG, Valentin P. Clinical presentation and treatment options for mitral valve myxoma. Ann Thorac Surg. 1997;64:872–7.
  4. Li Y, Pan Z, Ji Y. Herpes Simplex Virus Type 1 Infection Associated with Atrial Myxoma. American Journal of Pathology. 2003;163(6):2407–12.
  5. Castells E, Ferran V, Octavio de Toledo MC. Cardiac myxomas: surgi- cal treatment, long-term results and recurrence. J Cardiovasc Surg. Torino 1993;34:49–53.
  6. Keeling I, Oberwalder PJ, Schuchlenz H. Left ventricular outflow tract obstruction due to valve myxoma. Ann Thorac Surg. 2000;69:1591–2.
  7. Lappe DL, Bulkley BH, Weiss JL. Two-dimensional echocar- diographic diagnosis of left atrial myxoma. Chest. 1978;74:55–8.
  8. Acits Dato GM, De Benedictis M, Actis Dato A Jr. Long-term follow-up of cardiac myxomas (7–31 years). J Cardiovasc Surg. 1993;34:141–3.
  9. Bhan A, Mehrotra R, Choudhary SK. Surgical experiences with intracardiac myxomas:long-term follow up. Ann Thorac Surg. 1998;66(3):810–3.
  10. Murphy MC, Sweeney MS, Putnam JB Jr. Surgical treatment of cardiac tumors: a 25-year experience. Ann Thorac Surg. 1990;49:612–8.
  11. Wilkes D, McDermott D, Basson CT. Clinical phenotypes and molecular genetic mechanisms of Carney complex. 2005;6:501–8
  12. Carney JA. Differences between nonfamilial and familial cardiac myxoma. Am J Surg Pathol. 1985;9:53–5.
  13. Stratakis CA, Carney JA, Lin JP, Papanicolaou DA, Karl M, Kastner DL, et al. Carney complex, a familial multiple neoplasia and lentiginosis syndrome. Analysis of 11 kindreds and linkage to the short arm of chromosome 2. J Clin Invest. 1996;97:699–705.
  14. Casey M, Vaughan JH, Hatcher CJ, Winter JM, Weremowicz S, Montgomery K, et al. Mutations in the protein kinase A R1 regulatory subunit cause familial cardiac myxomas and Carney complex. J Clin Invest. 2000;106:R31–R38.
  15. Pinede L, Duhaut P, Loire R Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases. Medicine. (Baltimore) 2001;80:159–72.
  16. Chu PH, Jung SM, Yeh TS, Lin HC, Chu JJ. MUC1, MUC2 and MUC5AC expressions in cardiac myxoma Virchows Arch. 2005;446(1):52–5. Epub 2004 Nov 26.
  17. Smit SJ, Robinson NJ. Age-Specific Prevalence of Infection with Herpes Simplex Virus Types 2 and 1: A Global Review. J Infect Dis. 2002;186:S3–S28.