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Maurizio Rubino
Francesco Santini
Alessandro Mazzucco
Aldo Milano
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Ann Thorac Surg 1990;49:449-453
© 1990 The Society of Thoracic Surgeons


Articles

Surgical excision of intracardiac myxomas: A 20-year follow-up

Uberto Bortolotti, MD*, Giuseppe Maraglino, MD, Maurizio Rubino, MD, Francesco Santini, MD, Alessandro Mazzucco, MD, Aldo Milano, MD, Giuseppe Fasoli, MD, Ugolino Livi, MD, Gaetano Thiene, MD, Vincenzo Gallucci, MD

Departments of Cardiovascular Surgery, Cardiology, and Pathology, University of Padova Medical School, Padova, Italy

Accepted for publication November 20, 1989.

* Address reprint requests to Dr Bortolotti, Istituto di Chirurgia Cardiovascolare, Università di Padova, via Giustiniani, 2, 35128 Padova, Italy.

Since November 1968, 54 patients have undergone excision of an intracardiac myxoma, which was located in the left atrium in 46 (85%), in the right atrium in 6 (11%), and in the right ventricle in 2 (4%). There were 35 female and 19 male patients with a mean age of 48 ± 14 years (range, 7 to 68 years). Four patients were asymptomatic; the others were seen mostly with exertional dyspnea, palpitation, signs of systemic illness, and syncopal episodes. Before operation, embolic episodes occurred in 13 patients with a left atrial myxoma. There were two early (3.7%) and two late deaths (3.8%). Actuarial survival at 20 years is 91% ± 4%, and most of the current survivors are asymptomatic at a mean follow-up or 6.5 ± 5 years (range, 0.2 year to 20 years). Noninvasive reevaluation was performed with echocardiographic studies in 44 patients and 24-hour electrocardiographic monitoring in 34. No instances of tumor recurrence were observed, and there was a low incidence of major supraventricular arrhythmias late postoperatively. We conclude that excision of intracardiac myxomas is curative and long-term survival is excellent. The transseptal approach provides adequate exposure and allows complete removal of the tumor regardless of its location.




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