title: Surgical excision of cardiac myxomas: twenty years experience at a single institution.
abstract: BACKGROUND
  Primary cardiac tumors are quite uncommon and myxomas constitute the major proportion among these masses. The present study summarizes our 20-year clinical experience with surgical resection of intracardiac myxomas.
  
  
  METHODS
  Between January 1990 and December 2007, 98 patients (42 males, mean age 60.4±4.1 years) underwent complete excision of primary intracardiac myxoma. In 84 patients the origin site of the tumor was located in the left atrium, and the most common implant site was the interatrial septum. The most common symptom at admission was dyspnea, while systemic embolization was observed in 37 patients. Preoperative diagnosis was established in all patients by transthoracic echocardiography. All patients were operated through median sternotomy.
  
  
  RESULTS
  Ninety-five patients (97%) survived the operation. Mean tumor dimension was 2.7±1.3 cm in largest diameter. According to the St. John Sutton classification (St. John Sutton MG, Mercier LA, Giuliani ER, et al. Atrial myxomas: a review of clinical experience in 40 patients. Mayo Clin Pro 1980;55:371-6), solid tumors were detected in 43 patients (44%), while a papillary myxoma was found in 55 patients (56%). The follow-up was 100% complete, and the mean time to last follow-up was 98±60 months. Of the 95 survivors, 3 patients (3%) died at a mean follow-up of 72±45 months after surgery. Actuarial survival was 98%, 98%, and 89% at 5, 10, and 15 years, respectively. One patient operated for left atrial myxoma resection showed a recurrence 68 months after the first surgery.
  
  
  CONCLUSIONS
  Although cardiac myxomas carry the risk of severe systemic and cardiac symptoms, prompt surgical excision gives excellent early and long-term results.
authors.affiliation: Division of Cardiac Surgery and First Vascular Surgery Unit, Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Donato Hospital, San Donato Milanese, and Faculty of Medicine, University of Milan, Milan, Italy. agaratti@tiscali.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Garatti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Nano
authors.forename: Alberto
authors.initials: A
authors.lastname: Canziani
authors.forename: Piervincenzo
authors.initials: P
authors.lastname: Gagliardotto
authors.forename: Eugenio
authors.initials: E
authors.lastname: Mossuto
authors.forename: Alessandro
authors.initials: A
authors.lastname: Frigiola
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Menicanti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006338:Heart Neoplasms / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000401:mortality / Q000601:surgery*; D055815:Young Adult