title: Thirteen years follow-up of heart myxoma operated patients: what is the appropriate surgical technique?
abstract: BACKGROUND
  Cardiac myxoma is a benign neoplasm that represents the most prevalent primary tumor of the heart. If not treated with the right surgical technique recurrence occurs. Aim of our study is to present our surgical approach and the histology of the tumors resected.
  
  
  METHODS
  All patients, except for one, underwent extracorporeal circulation and mild hypothermia, right atrial or both atrial incision and excision of the fossa ovalis, followed by prosthetic patch suturing. All specimens were submitted for microscopic evaluation (haematoxylin-eosin). We contacted personally each patient and asked them to complete a standardized questionnaire, concerning their peri-operative characteristics.
  
  
  RESULTS
  Six cases were "active" myxomas, 3 were "mildly active" and 3 were "inactive". "Normal differentiation" was seen in 6, "medium" in 1 and "poor" in 5 cases. In our series there were no recurrences recorded during the follow-up period.
  
  
  CONCLUSIONS
  The ideal approach, according to our experience is right atrial or both atrial incision as described by Shumacker and King, with excision of the fossa ovalis and the surrounding tissues and closure with a pericardial patch. Such a technique provides an excellent long-term survival in these patients.
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Siminelakis
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Artemisia
authors.initials: A
authors.lastname: Kakourou
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kakourou
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Batistatou
authors.forename: Alexandra
authors.initials: A
authors.lastname: Batistatou
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Sokratis
authors.initials: S
authors.lastname: Sismanidis
authors.forename: Stelios
authors.initials: S
authors.lastname: Sismanidis
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Ntoulia
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Kosmas
authors.initials: K
authors.lastname: Tsakiridis
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Thalia
authors.initials: T
authors.lastname: Syminelaki
authors.forename: Theodora
authors.initials: T
authors.lastname: Syminelaki
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Efstratios
authors.initials: E
authors.lastname: Apostolakis
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Apostolakis
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Theodora
authors.initials: T
authors.lastname: Tsiouda
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Katsikogiannis
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Kougioumtzi
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Dryllis
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Machairiotis
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mpakas
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Thomas
authors.initials: T
authors.lastname: Beleveslis
authors.affiliation: 1 Department of Cardiothoracic Surgery and Department of Pathology, University Hospital of Ioannina, 45500 Greece ; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, Regional Hospital of Syros, Syros, Greece ; 6 Cardiology Department, "Saint Luke" Private Hospital, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
keywords: Surgery of myxomas; atrial myxoma; cardiac surgery