SURGICAL TREATMENT OF BENIGN CARDIAC TUMORS: A 33-YEAR SINGLE-CENTER EXPERIENCE.

Background: Primary cardiac tumors are extremely uncommon and the majority (80%) can be classified as benign. Myxoma is the most common histotype accounting for 50% of benign cardiac tumors (BCT). This study aims to present our 33-year experience in treating benign cardiac tumors, describing their epidemiological characteristics, and the surgical outcome for each specific subtype. Methods: Between January 1990 and December 2023, 176 patients (73 males, mean age 63±10 years) with benign cardiac tumors underwent surgery. We performed a retrospective analysis of the three most common benign subtype: solid myxomas, papillary myxomas and fibro-elastomas. Tumors were detected through Echocardiogram, CT scan and magnetic resonance imaging (MRI). Long-term survival and freedom from tumor recurrence were assessed with Kaplan- Meier analysis. Results: Among clinical presentations, most patients were asymptomatic (55%), while Heart failure (HF) symptoms were evident in 26% of patients, especially if presenting with solid myxomas. The most common origin site of myxomas was the left atrium (74%). All patients had complete excision and 31% underwent combined procedures. Postoperative complications were similar in all tumor subtypes, except for stroke which was significantly higher in papillary myxoma and fibroelastoma type. Overall 30-day mortality was 1.7%, without any differences among study groups. Overall cumulative survival showed no significant differences among tumor subtypes. Myxomas showed no significant long-term recurrence, while fibroelastoma showed a 10% recurrence at 20 years. Conclusions: In our experience, complete surgical excision is the gold standard therapy for benign cardiac tumors, with excellent short and long-term outcomes regardless of tumor type.