Atrial tumors--surgical experience of 9 cases

Nine patients underwent surgical removal of intracardiac tumor during a 12-year period. The mean age of the five women and four men was 57 years (range 40 to 69). Eight of the nine patients were operated on in the last four years of the study period. The interval from onset of symptoms to surgery averaged 18.3 months. Clinical presentation varied significantly, reflecting mechanical, embolic and constitutional effects of the intracardiac mass. Echocardiography was the noninvasive procedure that contributed most to preoperative diagnosis, confirming presence of an intracardiac tumor in seven of the eight examined patients. Of the nine intracardiac tumors, seven were myxomas (6 left atrial and 1 right atrial), one was a primary left atrial liposarcoma and one a right atrial metastasis from an anaplastic carcinoma of the kidney. No patient died during or immediately after the operation. The two patients with malignant tumor died, two months and two years postoperatively, from progression of the basic disease. In neither case, however, was atrial recurrence of tumor found at autopsy. Of the seven surviving patients, five are symptom-free after observation periods averaging 34 months (range 2 months to 12 years). The other two still have signs of mild congestive heart failure. No recurrence of atrial myxoma has so far been detected.