[Follow-up using echocardiography and ambulatory electrocardiography of patients after excision of intracardiac myxoma].

From November 1968 to May 1990, 56 patients, 19 male and 37 female (mean age 49 +/- 14 years) underwent excision of an intracardiac myxoma (M). M was located into the left atrium in 48 (86%), the right atrium in 6 (11%), and the right ventricle in 2 (3.5%). Operation consisted of excision of the tumor together with its base of attachment. There were 2 early (3.5%) and 2 late (3.7%) deaths. Actuarial survival at 20 years is 91 +/- 4%. Non-invasive reevaluation has been carried out in 44 patients (84%), 39 with left atrial M, 4 with right atrial M, and 1 with right ventricular M. 2-D echocardiography ruled out tumor recurrence in all patients and showed, in those with left atrial M, a reduction in the size of the atrial chamber; on the contrary, left ventricular systolic diameter, diastolic diameter and ejection fraction were unmodified. In 7 patients (15.9%) a residual mild mitral insufficiency was disclosed. In 34 patients 24-hour electrocardiographic monitoring reevaluation showed a low incidence of major supraventricular arrhythmias, late postoperatively (short runs of paroxysmal supraventricular tachycardia in 3 patients, and atrial ectopic rhythm in 1). All these patients had undergone tumor excision by biatrial approach. Based on our results, we conclude that excision of intracardiac myxomas is curative and long-term survival is excellent. Non-invasive reevaluation of patients by 2-D echocardiography and 24-hour electrocardiographic monitoring is mandatory in order to promptly disclose possible complications, particularly tumor recurrence and arrhythmias.