BACKGROUND: Thirty-five patients with an intracardiac myxoma underwent
excision of the tumor in Hawaii between 1974 and 1993. PATIENTS AND M
ETHODS: There were 28 female and 7 male patients in the group, Their a
ges ranged from 11 to 79 years (mean 48) with the majority (71%) betwe
en 30 and 60 years old, The patients' medical records were reviewed an
d special attention was paid to clinical presentation, methods of diag
nosis, operative findings, and postoperative course, RESULTS: No ethni
c predisposition was found, Forty-six percent of the presenting sympto
ms were cardiac (congestive heart failure 26%, palpitations 14%, and s
yncope 6%) while arterial embolization accounted for 11%, Diagnosis wa
s made by angiography, echocardiography, or gated cardiac blood pool i
maging, Ah were reliable, but two-dimensional (2-D) echocardiography w
as used most often, with no false-positive or false-negative results.
There were 32 left atrial, 2 right atrial, and 1 biatrial myxomas, Lim
ited septectomy was performed in most cases, but 9 patients (26%) requ
ired Dacron patch repair of the atrial septum, There was 1 death from
a cerebrovascular accident the day after the removal of a left-sided a
trial myxoma, Other patients had few minor postoperative complications
, One patient presented with a recurrence 8 years after resection at a
nother institution; no further recurrences were found. CONCLUSIONS: We
conclude that due to the nonspecific presentation of atrial myxoma, a
high index of suspicion is needed, The diagnostic method of choice is
2-D echocardiography, Limited septectomy is a safe procedure, but clo
se follow-up for at least 10 years may be needed to rule out recurrenc
e.