The surgical treatment of atrial myxomas: clinical experience in 6 patients.

ABSTRACT

Six patients from 17 to 73 years of age (mean age 37.3 years) underwent excision of atrial myxomas between November 1990 and August 1994 at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Chiang Mai. There were 4 females and 2 males. All the tumors were located in the left atrium, no right atrial or ventricular tumors were identified. Four patients presented with congestive heart failure, one with tachyarrhythmia, and one with cerebral embolism. Symptoms were present from 1 to 80 months before operation. Physical examination revealed murmur of mitral insufficiency in 4 patients, bibasilar rales in 2 patients and peripheral edema in 2 patients. Electro-cardiographic analysis demonstrated that 4 of 6 patients were in sinus rhythm and atrial fibrillation in the remaining patients. All the patients were diagnosed by two-dimensional echocardiography. The myxomas were successfully removed in all patients utilizing extracorporeal cardiopulmonary bypass without hospital mortality. In the early follow-up period (2-27 months), 5 patients are in New York Heart Association class I and one patient is in class II. No recurrent myxomas have been identified clinically in any patient. In this report, good results were obtained by simple excision of the tumor. Long-term clinical and echocardiographic follow-up is recommended since late recurrence, although rare, has been reported.