Long-term outcomes after surgical resection of atrial myxoma: a 13-year experience at a tertiary referral centre

Background/Introduction Atrial myxoma is the most common primary cardiac tumour and, despite its benign histology, may cause life-threatening hemodynamic obstruction or embolic events. Surgical excision is the definitive treatment, yet contemporary long-term outcome data from tertiary centres remain limited. Such data are essential for benchmarking practice and informing modern perioperative and follow-up strategies. Purpose To provide contemporary evidence on long-term outcomes after atrial myxoma resection, addressing a clear gap in the existing literature. The study aims to evaluate survival and postoperative morbidity, particularly atrial fibrillation, in a large consecutive cohort, in order to inform clinical decision-making, patient counselling, and long-term management. Methods A retrospective review was conducted of all consecutive patients who underwent surgical resection of a pathologically confirmed atrial myxoma between 2012 and 2025. Demographic, clinical, operative, and postoperative data were obtained from a prospectively maintained cardiac surgery database. Primary endpoints were long-term all-cause mortality and late-onset atrial fibrillation. Survival was analysed using Kaplan–Meier methods. Results The study cohort comprised 84 patients (mean age 63.6 ± 12.3 years; 77% female) with a mean follow-up of 5.39 ± 3.89 years. Dyspnoea was the most common presenting symptom (47.6%), and 15.5% were asymptomatic. The left atrium was the site of origin in 89.4% of cases. In-hospital mortality was 0%. New-onset postoperative atrial fibrillation occurred in 23.8% of patients during the index admission. Actuarial survival was 97.6% at 1 year, 89.3% at 5 years, and 78.6% at 10 years. Conclusions Surgical resection of atrial myxoma is safe and highly effective, with excellent early outcomes and long-term survival comparable to the general population. Postoperative atrial fibrillation is the predominant source of long-term morbidity and should be a focus of structured postoperative surveillance and management. This study provides important contemporary outcome data and underscores the curative potential of surgery while highlighting the importance of managing postoperative arrhythmic complications in atrial myxomas.