[Cardiac myxoma: surgical results and 15-year clinical follow-up].
BACKGROUND
Among cardiac tumors myxoma is the most common benign neoplasm. The aim of this study was to review our Institution's 15-year experience with intracardiac myxoma.


METHODS
From 1985 through 2001, 38 patients (22 males, 16 females, mean age 57.06 +/- 11.1, range 32-74 years) underwent surgical resection of a cardiac myxoma at our Institution. The tumor was located in the left atrium in 29 patients (76.3%), in the right atrium in 8 patients (21%), and in the right ventricle in 1 patient (2.6%). The duration of symptoms prior to surgery ranged from 2 to 30 days. None of the patients had a familial myxoma. The surgical approach comprised complete wide excision in all patients. The incidence of delayed death, thromboembolic complications, valve degeneration, recurrence and reoperation were reviewed and the Kaplan-Meier survival curve was elaborated.


RESULTS
There were no perioperative deaths. Three patients (7.9%) developed postoperative neurological sequelae: transient ischemic attacks in 2 patients (5.2%) and a stroke with persistent neurological deficit in 1 patient (2.6%). One patient (2.6%) required pacemaker implantation for complete atrioventricular block. An inferior myocardial infarction occurred in 1 patient (2.6%). During the follow-up, complete in 89.4% of the patients (34 out of 38 patients, mean 96.8 +/- 68.4 months, range 1-218 months), there were 2 (5.8%) non-cardiac related deaths. All the patients underwent clinical examination and echocardiography at regular intervals (1 year): no neurological event was observed during the follow-up and 29 patients (90.6%) are in NYHA functional class I. At 15 years the event-free rate is 85.2%. At 15 years the actuarial survival for the whole group is 92%.


CONCLUSIONS
At present, the diagnosis of myxoma is easy to make and two-dimensional echocardiography plays a major role in this field. Surgery is the gold standard treatment and the clinical long-term results are excellent.
Divisione di Chirurgia Cardiovascolare, Ospedale L. Sacco Via G.B. Grassi, 74, 20157 Milano. scrofani@robertomail.it
Roberto
R
Scrofani
Cristina
C
Carro
Livio
L
Villa
Mario
M
Botta
Carlo
C
Antona
D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria; D006338:Heart Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D013997:Time Factors