It was sought to determine whether recurrent cardiac myxomas had special etiological, surgical and/or pathological features differentiating them from usual forms. This involved study of 6 recurrences occurring in 85 patients treated surgically between 1959 and 1989, as well as 33 well documented recurrences in the literature. True recurrent myxomas in young adults have a definite familial nature, frequently occurring within the context of Craney's complex and are due to a multicentre onset. Closer postoperative monitoring is therefore required in such cases. Recurrence of sporadic myxomas is generally due to incomplete excision and can be avoided by precautions regarding operative technique.