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Atrial myxomas: experiences with 35 patients in Hawaii.

AbstractBACKGROUND:
Thirty-five patients with an intracardiac myxoma underwent excision of the tumor in Hawaii between 1974 and 1993.
PATIENTS AND METHODS:
There were 28 female and 7 male patients in the group. Their ages ranged from 11 to 79 years (mean 48) with the majority (71%) between 30 and 60 years old. The patients' medical records were reviewed and special attention was paid to clinical presentation, methods of diagnosis, operative findings, and postoperative course.
RESULTS:
No ethnic predisposition was found. Forty-six percent of the presenting symptoms were cardiac (congestive heart failure 26%, palpitations 14%, and syncope 6%) while arterial embolization accounted for 11%. Diagnosis was made by angiography, echocardiography, or gated cardiac blood pool imaging. All were reliable, but two-dimensional (2-D) echocardiography was used most often, with no false-positive or false-negative results. There were 32 left atrial, 2 right atrial, and 1 biatrial myxomas. Limited septectomy was performed in most cases, but 9 patients (26%) required Dacron patch repair of the atrial septum. There was 1 death from a cerebrovascular accident the day after the removal of a left-sided atrial myxoma. Other patients had few minor postoperative complications. One patient presented with a recurrence 8 years after resection at another institution; no further recurrences were found.
CONCLUSIONS:
We conclude that due to the non-specific presentation of atrial myxoma, a high index of suspicion is needed. The diagnostic method of choice is 2-D echocardiography. Limited septectomy is a safe procedure, but close follow-up for at least 10 years may be needed to rule out recurrence.
AuthorsS Premaratne, N W Hasaniya, H Y Arakaki, M M Mugiishi, R T Mamiya, J J McNamara
JournalAmerican journal of surgery (Am J Surg) Vol. 169 Issue 6 Pg. 600-3 (Jun 1995) ISSN: 0002-9610 [Print] United States
PMID7771624 (Publication Type: Journal Article)
Topics
  • Adolescent
  • Adult
  • Aged
  • Angiography
  • Child
  • Echocardiography
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Gated Blood-Pool Imaging
  • Hawaii
  • Heart Atria
  • Heart Neoplasms (diagnosis, surgery)
  • Humans
  • Male
  • Middle Aged
  • Myxoma (diagnosis, surgery)
  • Physical Examination
  • Postoperative Complications
  • Predictive Value of Tests
  • Prognosis

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