Surgical experience with intracardiac myxomas

Eighteen patients underwent surgery for intracardiac myxoma (16 left atrial and 2 right atrial) during the last 10 years. Seventeen patients had tumour stalk attached to the oval fossa. The myxoma was excised along with a cuff of the atrial septum, which was reconstructed using a Dacron patch in 15 patients and by direct suture in 2 patients. In the remaining case the myxoma was attached to the left atrial wall and adjacent atrioventricular junction. There was only one early death in a patient who underwent a concomitant lobectomy for lung abscess and one late death due to a noncardiac cause. During the follow-up period of 3-96 months (average 36 months) all the survivors were in New York Heart Association Class I. Scanning electron microscopy of tumour tissue was done in 8 cases. The morphological findings did not help in categorizing the tumours into any pathological subgroups. Postoperative cardiac catheterization done in 3 patients (30-50 months postoperatively) showed return of haemodynamics to normal. Echocardiographic studies done postoperatively have not revealed recurrence of tumour in any patient. Surgical excision of myxomas is possible with very gratifying long-term results.