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Ann Thorac Surg 1984;38:53-58
© 1984 The Society of Thoracic Surgeons

Articles

Approach in the Management or Atrial Myxoma with Long-term Follow-up

Mehdi A. Marvasti, M.D.*, Anis I. Obeid, M.D., James L. Potts, M.D., Frederick B. Parker, M.D.

Departments of Surgery and Medicine, State University of New York, Upstate Medical Center, Syracuse, NY

Accepted for publication January 5, 1984.

* Address reprint requests to Dr. Marvasti, Department of Surgery, Upstate Medical Center, 750 E Adams St, Syracuse, NY 13210

Between 1972 and 1982, 9 patients underwent successful excision of atrial myxomas at the Upstate Medical Center. Eight patients had a left atrial myxoma and 1 a biatrial myxoma. There were 5 female and 4 male patients ranging from 16 to 63 years of age. Preoperative findings consisted of cerebral or peripheral emboli, congestive heart failure, and nonspecific symptoms. Diagnosis was confirmed by echocardiography and angiography in all but 1 patient. A biatrial operative approach was utilized in all patients except 1. Complete excision of the tumor with a cuff of normal tissue was performed. All heart chambers were carefully explored for presence of multicentric myxomas or tumor debris. There were no operative deaths or intraoperative embolizations. Follow-up has been 11/2 to 11 years. There has been 1 late noncardiac death. All patients underwent echocardiography postoperatively with no recurrence. The risk of intraoperative embolization and late recurrence is minimal with the biatriotomy technique. Two-dimensional echocardiography is extremely accurate in early diagnosis of myxomas and in the late follow-up of patients.




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