Surgical Treatment for Cardiac Myxomas-a Review of 13 Cases-

Thirteen patients with primary cardiac myxoma surgically treated in our hospital between October 1976 and November 1994 were a assessed in regard to the long-term outcome of surgical management. There were seven men and six women, 15 to 73 years old at the time of surgery (average age: 50). In addition to cardiac myxoma, preoperatively five patients had heart failure, two cerebral embolism, and one cardiac arrest, and 11 of the 13 patients had leukocytosis or high C-reactive protein (CRP) levels. The tumor arose in the left atrium in 12 patients and in the right ventricle in one patient. The left atrial myxomas were exposed by transseptal atriotomy in seven patients, transverse biatriotomy (Dubost incision) in three and bilateral longitudinal atriotomy and left atriotomy from the right side in one patient each. The right ventricular myxoma was excised by right atriotomy. Supraventricular arrhythmia occurred in six patients (46%), cerebral embolism in two, and respiratory failure, acute renal failure, low-output syndrome (LOS), and heart failure in one patient each in the early postoperative period. There was one surgical death caused by LOS secondary to preoperative cardiac arrest and one hospital death due to heart failure secondary to residual mitral regurgitation after mitral annuloplasty. One patient died of a cerebrovscular accident in the late period possibly secondary to recurrent myxoma. We emphasize the necessity of strict postoperative follow-up for probable tumor recurreuce and secondary cerebral infarction.