ATRIAL-MYXOMA - NATIONAL INCIDENCE, DIAGNOSIS AND SURGICAL-MANAGEMENT

Despite being the most common benign intracardiac tumour with an excel lent prognosis after surgical excision the incidence of atrial myxoma (except at autopsy) is unknown. We reviewed all patients admitted to t he National Cardiac Surgery Unit (n=26) with an atrial myxoma over a f ifteen year period (1977-1991) to compile national incidence data and assess pre-operative diagnosis, management, surgical technique, and ou tcome. Preoperative symptoms were: congestive cardiac failure (12 pati ents), embolism (8 patients), constitutional (3 patients), asymptomati c (2 patients) and tachyarrhythmia (1 patient). The diagnosis was conf irmed by 2D echocardiography alone in thirteen patients and by a combi nation of echocardiography and angiography in thirteen patients. At op eration the site of the tumour was left atrial in 24 patients and bi-a trial in two patients. All cases were confirmed by histology. All pati ents made a good post-operative recovery, although one patient survive d a pulmonary embolus and one patient developed a deep venous thrombos is. There has been one late death (five months after surgery) from a c erebrovascular accident. Serial echocardiography has revealed one recu rrence to date (8 years after surgery). The surgical incidence of thes e tumours in the Republic of Ireland over the study period was 0.5 atr ial myxomas/million population/year. Although rare atrial myxomas are the most important cardiac tumours to diagnose as the results from sur gery are excellent.