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The Annals of Thoracic Surgery, Vol 49, 449-453, Copyright © 1990 by The Society of Thoracic Surgeons
U Bortolotti, G Maraglino, M Rubino, F Santini, A Mazzucco, A Milano, G Fasoli, U Livi, G Thiene and V Gallucci
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 of 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.
ARTICLES
Surgical excision of intracardiac myxomas: a 20-year follow-up
Department of Cardiovascular Surgery, University of Padova Medical School, Italy.
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