Left Atrial Myxoma: Experience with Different Approaches Including Superior Transseptal Approach

Forty-nine patients underwent surgical excision of left atrial myxomas during a period of 14 years (1982 to 1995). There were 25 male and 24 female patients. In all cases, the diagnosis was based on clinical examination and echocardiography; cardiac catheterization was performed in 9 patients. We considered the diagnosis of myxoma as an indication for early surgery. The myxoma was excised using various approaches: right atrial transseptal incision (38), biatrial incision (9) and superior transseptal approach (2). The latter approach has not been utilized for excision of myxoma before. One patient died in the early postoperative period. New cardiac arrhythmias were observed in 4 patients while the others had an uneventful recovery. Forty-two patients returned for follow-up over a period ranging from 0.4 to 13.6 years. They were evaluated clinically and echocardiographically. All have recovered well and we conclude that left atrial myxoma can be treated with low mortality and morbidity.