# Early and Midterm Outcomes of Atrial Myxoma Resection Via Superior Transseptal Approach

## TL;DR

This study shows that a specific surgical technique for removing heart myxomas is safe and effective with no deaths or recurrences.

## Contribution

The study demonstrates the safety and efficacy of the superior transseptal approach for atrial myxoma resection.

## Key findings

- No in-hospital mortality or tumor recurrence was observed in patients undergoing the superior transseptal approach.
- Postoperative atrial fibrillation occurred in 50% of patients, but no permanent pacemakers were needed.
- The technique enabled complete tumor removal with acceptable complication rates over a 3.5-year follow-up.

## Abstract

Atrial myxomas are the most common primary cardiac neoplasms, typically presenting with obstructive cardiac symptoms or embolic events. Surgical excision remains the definitive treatment; however, concerns persist regarding surgical exposure, postoperative arrhythmia, and recurrence. This study compared the early and mid-term outcomes of atrial myxoma excision performed exclusively using the superior transseptal technique with outcomes reported in the current literature.

This retrospective cohort study included 10 patients who underwent surgical resection of atrial myxoma using a superior transseptal approach between January 2018 and December 2025. Demographic, preoperative, intraoperative, and postoperative data were collected. Outcomes analyzed included perioperative morbidity and mortality, rhythm disturbances, recurrence, and length of hospital stay.

The cohort consisted of 7 women and 3 men with a mean age of 52.9 ± 9.0 years. Dyspnea was the most common presenting symptom (70%), and embolic events occurred in 10% of patients. All tumors were excised en bloc with a surrounding margin of septal tissue; 100% required atrial septal defect closure using an autologous pericardial patch. Postoperative atrial fibrillation was observed in 50% of patients, though none required permanent pacemaker implantation. There was no in-hospital mortality or tumor recurrence during a mean follow-up period of 3.5 ± 1.6 years.

The superior transseptal approach provided optimal exposure and enabled safe, effective resection of atrial myxomas, resulting in no mortality, no recurrence, and acceptable complication rates. These findings support the use of this technique as a reliable strategy in the surgical management of atrial myxomas.