Surgical excision of atrial myxomas: 20 years experience of our department

Abstract

Atrial myxomas are the most common forms of primary heart tumors. The clinical symptomatology is non-specific and very varied according to the anatomical forms and the localization. The objective of this study is to evaluate our immediate and medium-term results as well as to update surgical procedures. It is a retrospective study including 18 patients (11 men and 7 women) with a mean age of 50 years, with extremes ranging from 23 to 76 years, operated between January 1999 and March 2019 for atrial myxoma which location was in left atrium for 11 patients and in right atrium for 7. The main clinical symptom when discovering the disease was the appearance of recent dyspnea in 33% of cases. The base of insertion of the tumor was predominantly septal in 12 cases (66.7%) with an average size of 47.6 mm. The resection of the myxoma took away its implantation base, with a margin of safety in the healthy atrial or septal's tissue. Repair of the defect was carried out by direct suturing in 7 cases and the rest was done by a bovine pericardial patch. Concomitant valve surgery was performed in 27% of cases. No immediate or medium term mortality. The average follow-up is 26 months. Functionally, patients have become asymptomatic again. Subsequent monitoring by echocardiography revealed the absence of tumor recurrence but a presence of a small residual ASD in 2 cases ( Fig. 1 ). Myxomas are a rare primary tumors of the heart with a varied symptomatology. Echocardiography remains the main tool for diagnosis and follow-up. Surgery is the gold standard for treatment that remains burdened with low morbidity and mortality. The evolution is usually favorable, nevertheless, the recurrence remains possible justifying a regular clinical examination and echographic supervision.