Surgical excision of intracardiac myxomas: a 20-year follow-up.
Since November 1968, 54 patients have undergone excision of an intracardiac myxoma, which was located in the left atrium in 46 (85%), in the right atrium in 6 (11%), and in the right ventricle in 2 (4%). There were 35 female and 19 male patients with a mean age of 48 +/- 14 years (range, 7 to 68 years). Four patients were asymptomatic; the others were seen mostly with exertional dyspnea, palpitation, signs of systemic illness, and syncopal episodes. Before operation, embolic episodes occurred in 13 patients with a left atrial myxoma. There were two early (3.7%) and two late deaths (3.8). Actuarial survival at 20 years is 91% +/- 4%, and most of the current survivors are asymptomatic at a mean follow-up of 6.5 +/- 5 years (range, 0.2 year to 20 years). Noninvasive reevaluation was performed with echocardiographic studies in 44 patients and 24-hour electrocardiographic monitoring in 34. No instances of tumor recurrence were observed, and there was a low incidence of major supraventricular arrhythmias late postoperatively. We conclude that excision of intracardiac myxomas is curative and long-term survival is excellent. The transseptal approach provides adequate exposure and allows complete removal of the tumor regardless of its location.
Bortolotti
U
U
Department of Cardiovascular Surgery, University of Padova Medical School, Italy.
Maraglino
G
G
Rubino
M
M
Santini
F
F
Mazzucco
A
A
Milano
A
A
Fasoli
G
G
Livi
U
U
Thiene
G
G
Gallucci
V
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery; D006338:Heart Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006346:Heart Septum / Q000601:surgery; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D009232:Myxoma / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D015996:Survival Rate