Clinical features and surgical treatment of right atrial tumors: a retrospective analysis of 64 cases

Objective To investigate the clinical characteristics of right atrial tumors and to analyze the experience and efficacy of surgical treatment. Methods The clinical data of 64 patients (37 females and 27 males, at a mean age of 47.0±16.4 years) with right atrial tumors admitted to our hospital from January 2009 to January 2021 were retrospectively collected and analyzed. The clinical features, surgery techniques adopted, postoperative complications and metastatic recurrence of patients were summarized in detail. Results Among all the 64 cases, benign tumors accounted for 78.1% and malignant tumors for 21.9%; while among the 53 patients who underwent surgical treatment, 83.0% of the tumors were benign and 17.0% malignant. The top 3 most common clinical symptoms involved fatigue, chest tightness and pain or precordial discomfort, and facial or lower limbs edema. And the most frequent preoperative complications were atrial fibrillation/flutter, followed by pulmonary embolism. Moreover, the overall in-hospital mortality rate was 3.1%, and the postoperative mortality rate 1.9%. Among the patients with benign tumors, 1 had residual tumor thrombus at the distal end of inferior vena cava, 1 occurred arrhythmia requiring surgical intervention, 3 developed moderate to severe tricuspid regurgitation, and 2 had metastatic recurrences. In the patients with malignant tumors who received surgery, 1 died early postoperatively, 6 developed metastatic recurrences between half a month and 2 years plus 7 months, and 2 cases were lost during follow-up. Conclusion Primary benign tumor is the major type of right atrial tumors. Surgical treatment for benign tumors is safe and effective, even in recurrent cases. Selective surgical treatment for malignant tumors can improve hemodynamics and clinical symptoms, though the overall prognosis tends to be poor.