Atrial myxoma: trends in management

Myxomas are the most common type of cardiac tumours in all age groups accounting for one-third to one-half of cases at postmortum and for about three quarter of tumours treated surgically. Most atrial myxomas, whether left or right, arise from the atrial septum. About 10% have other sites of origin, particularly posterior wall, anterior wall and the appendages (in order of frequency). Myxomas are frequently located in left atrium and produce symptoms when they fragment and cause systemic emboli or when they interfere with cardiac valvular function and cause pulmonary congestion. Careful surgical management of these lesions should be curative with minimal early and late morbidity and mortality. Recurrence of atrial myxomas can occur most likely in about 3% of patients. However, extensive resection of the myxoma attached to atrial septum or atrial wall can reduce the likelihood of recurrence to a greater extent. Long term clinical and echocardiographic follow-up is mandatory.