Delayed neurologic complications of left atrial myxoma.

We studied the delayed neurologic complications of left atrial myxoma in 2 patients and analyzed 47 previously published cases. Embolic cerebral infarctions may occur before surgical removal of the primary cardiac tumor, but aneurysm formation and hemorrhage may be delayed, whether or not there is evidence of neurologic disorder at the time of initial surgery. The true incidence of these delayed complications is unknown. Resultant aneurysms may show progressive enlargement, and treatment with doxorubicin failed to prevent aneurysm enlargement in one patient. Better guidelines are needed for clinical management in these patients.