1F). Two patients who had aortic valve repair for papillary fibroelastoma have been reoperated after 67 and 51 www.selleckchem.com/products/nutlin-3a.html months respectively because of development of severe aortic regurgitation due to failure of previous valve repair. One patient who had a mitral valve repair due to papillary fibroelastoma of anterior mitral chords has been re-operated after 112 months because of severe mitral regurgitation. Ten patients died during the follow-up period (11%), 3 because of car accident, 4 because of extra-cardiac neoplasm, 1 because of myocardial infarction after 46 months from the operation and two for respiratory infection. Twenty-four patients had at least an episode of detected atrial fibrillation during the follow-up period (19 myxomas, 4 fibroelastoma, 1 angiomyolipoma) after a mean-time from the operation of 18��34months.

Thirteen of these patients (54.2%) had atrial fibrillation as presentation symptom of neoplasm. Nine of these 24 patients (37.5%) have developed chronic atrial fibrillation treated with anti-arrhythmic drugs and anticoagulant therapy. Four of these patients (16.7%) underwent associated procedure (1 bentall, 2 mitral valve repair, 1 ablation for chronic atrial fibrillation). No embolic complications have been documented. After one-year follow-up the patient with HMCM is asymptomatic and in good clinical condition, without increase of the residual tumor diameter. The patient with leiomyosarcoma died 9 months after the operation. The patient with fibrosarcoma died 26 months after the operation. The patients with angiosarcoma died after 5 and 7 months respectively.

Discussion and conclusions In 1559 was certified for the first time the existence of cardiac neoplasm (3). A classification system of primary cardiac tumors similar to what we use today has been introduced by Yater in 1931 (4), the first ante-mortem diagnosis was made by Barnes in 1934 (5). The first surgical excision was performed by Bahnson and Newman in 1952. In 1954 Crafoord removed an atrial myxoma by using extracorporeal circulation (6). Nowadays in a high volume cardiac surgery department primary cardiac tumors are an uncommon but not rare entities. Between January 1990 to May 2010 we performed in our department 22093 cardiac operations, 91 of these were for primary cardiac tumors, representing the 0.4% of all operations. Autopsy studies reported a prevalence of primary cardiac tumors ranging from 0.

001 to 0.3% (1). It has been estimated that surgery for cardiac tumors represent about 0.3% of all open-heart procedures (7,8). In details during the first decade of our experience we diagnosed 22 primary cardiac tumors representing 0.2% (22/9189 operations) of total surgical activity. In the meantime in the second decade of our experience we diagnosed Cilengitide 69 primary cardiac tumors representing the 0.5% (69/12904 operations) of total surgical activity.