[The surgical treatment of cardiac myxomas: 10 years of experience]

Abstract

Over a ten-year period (September 1980-July 1990) 3172 patients underwent open heart surgery in our hospital. Twenty five patients (0.78%) had a cardiac myxoma. There were 18 female and 7 male patients, mean age of 32.3 +/- 21 years (4-61). Left atrial myxomas were diagnosed in 18 patients, left ventricular myxoma in three, right atrial myxoma in two, and one in right ventricle; there was a biatrial myxoma in one case, another had biatrial and left ventricular myxoma. The clinical manifestations of right sided myxomas was congestive heart failure. Patients with left myxoma frequently presented embolic episodes. Myxoma diagnosis was made by means of chest films, EKG and two-dimensional echocardiography which proved effective in twenty four of our patients; cardiac catheterization was performed in ten of them. Symptoms before diagnosis lasted an average of 16.3 months and mean time from diagnosis to operation was 6.6 days. Different surgical approaches are analyzed and discussed. Concomitant surgical procedures were performed in five patients: mitral annuloplasty in one, mitral valve replacement in four (two biological and two mechanical prosthesis). In eight patients the resulting septal defect due to resection of pedicle was closed with pericardial or dacron patches. There were two operative deaths due to pulmonary emboli in one and multiple organ failure in other. Cardiac myxoma is the more frequent primary neoplasm of the heart; its "benign" nature is doubtful; cure by surgical excision can be considered in vast majority of patients and its morbidity is reasonably low.