CARDIAC MYXOMA - 40 YEARS EXPERIENCE IN 63 PATIENTS

Background. Cardiac myxomas were resected in 63 patients, including th e first successful procedure in the world. Methods. Patient data and d ata obtained during follow-up of the survivors were reviewed. Results. Preoperatively, valve obstruction occurred in 56% and emboli in 32% o f the patients. The myxomas were located in the left atrium in 88%, ri ght atrium in 10%, and both atria in 1 patient (1.6%). One patient die d early, and 5 died late. The 20-year survival rate was 85%. At a medi an of 13 years (range, 1 month to 42 years) after resection, 26% of th e survivors reported having various cardiopulmonary symptoms, 5% had h ad thromboembolic events, and 69% were asymptomatic. After 2 years, th ere was a recurrence in a young woman who had had a multifocal myxoma at the time of the primary operation. No other evidence of recurrence was found at autopsy or during repeat echocardiography in the remainin g patients during an observation period of 787 patient-years. Conclusi ons. Surgical resection of a single myxoma is a safe and effective tre atment, with a low risk of recurrence. After uncomplicated resection, the frequency with which postoperative echocardiography is performed s hould be limited. (C) 1997 by The Society of Thoracic Surgeons.