Clinicopathological correlates of cardiac myxomas: a 30-year experience

Between 1961 and 1991, 23 patients (eight men and 15 women, with a mean age of 50 (range 25-72) years) with cardiac myxomas were managed at the Alfred Hospital, Prahran, Victoria, Australia. Symptoms of mitral valve obstruction were present in 13 patients and of systemic embolism in nine. In the patients, 21 myxomas were confined to the left atrium. In the other two patients, one myxoma was confined to the right atrium and the other was a dumb-bell-shaped biatrial myxoma. Most tumours were diagnosed with echocardiography. Removal was achieved via a median sternotomy and by entering the involved chamber. Those myxomas presenting with systemic embolism were always soft and friable, whereas those with obstructive symptoms were large and of variable consistency. There was one operative death early in the series. The 22 surviving patients have been assessed as functional class I of the New York Heart Association at follow-up, ranging from 2 months to 23 years (mean 9 years). There were no episodes of tumour recurrence. Excellent short, intermediate and long-term results can be achieved by excision of cardiac myxomas.