Data on 32 consecutive patients undergoing resection of a cardiac myxoma over a 20-year period (1971-1991) was analyzed. The mean age of the patients was 57 +/- 11 years (range 36 to 78). All myxomas were located in the left atrium except one right ventricular tumor. Ten of the atrial resections were performed with only an endocardial cuff while a full thickness atrial septum cuff was removed in 21 cases. One patient, operated under emergency conditions, died 11 days later as a result of cardiac and pulmonary failure (hospital mortality 3.1%). Late follow-up (mean 6.4 +/- 4.4 years) shows excellent results. All patients are alive and well. No recurrences have been found. In this series, good long-term results were obtained by simple excision of cardiac myxomas. This finding supports the theory that recurrence is mainly confined to patients with familial presentation and/or myxoma complex.