Surgical treatment of cardiac myxomas: 16 years experience of 78 patients

Aims: Primary heart tumors are rare. Of these 75% were benign, and 50% myxomas. The cardiac myxoma represents the most common benign intracardiac tumor. Between 1989 and 2005, 78 patients underwent surgery for cardiac myxoma at our institution. Methods: We retrospectively analyzed the results according to preoperative symptoms, operative procedures and postoperative outcome of cardiac myxomas. Results: Seventy-eight patients were investigated, 52 (67%) were female, the mean age was 56 years. Symptoms were dyspnea, angina, rhythm disorders, and neurological symptoms caused by embolism. One patient developed myocardial infarction and two patients pulmonary hypertension. 58 (74%) myxomas were located in the left, 6 in the right atrium, three occurred in the left, two in the right ventricle. 5 patients showed an infiltration of mitralvalve and two of the tricuspid valve. The interatrial approach was made from the right upper pulmonary vein, strait through the interatrial septum. Optimal overlook and minimally risk of embolism by tumor material was guaranteed. The duration of CPB was 65 minutes, the operation time was 2.5 hours. The hospital stay was 7 days. Two patients (2.5%), with preoperative decompensation, died after tumor resection, from progressive low-cardiac output. Mean survival was 8.3 years and during long-time follow-up (15 Years), another 9 patients died from non cardiac diseases. Two patients (2.5%) underwent second resection after recurrence of single cardiac myxoma, both after 6 years. Conclusion: Surgical resection of a single myxoma is a most effective treatment, with low risk of recurrence and perioperative death.