Surgical treatment of cardiac tumors: a 5-year experience from a single cardiac center

Abstract

Background: Cardiac tumors are rare but manifested with various clinical presentations and often cause unexpected symptoms or sudden death. The objective is to review the clinical presentation, histopathological spectrum, mortality and follow-up data of patients with cardiac tumors following surgery treatment over a period of 5 years. Methods:We retrospectively collected the medical records of all patients diagnosed of cardiac tumors in the period between January 2008 and December 2013 at the cardiac center of our university. Clinical histories, perioperative data, surgical findings, efficacy and follow-up data were reviewed in our study.Patients were divided into two groups according to site distribution of the tumors in the heart.Results: A total of 131 patients underwent surgical treatment of cardiac tumors were enrolled in this study, with a mean age of 51.39±16.37. The result of analysis showed that 79.47% (n=104) of the primary intracardiac tumors were benign, while primary malignant neoplasms accounted for 16.03% (n=21) of all patients, with the remainder (n=6, 4.6%) metastatic tumors transferred from other organs. Among all patients there were 2 in-hospital deaths and the survival rate in all patients at 1-year, 3-year and 5-year follow up was 83.20%, 78.62% and 66.41% respectively. Both patients with tumors in the left and right heart had similar basic characteristics except sex gender (P=0.002), BSA (P=0.045) and weight (P=0.033). Compared with patients with tumors in the right heart, patients with tumors in the left heart had significant higher CPB time (P<0.001), cross clamp time (P<0.001) and time of mechanical ventilation (P<0.001), and they also had longer ICU stay (P<0.001) but not total hospital stay (P=0.434).Conclusions: Surgical resection represents an effective protocol in treating cardiac tumors. Data in our study of cardiac tumors on frequency and allocation were consistent with previous reports which may provide useful clinical evidence on shared data, and data revealed that patients with malignant cardiac tumors had significant lower survival both in hospital and long-term follow-up.

Outcome and Pathological Characteristics of Primary Malignant Cardiac Tumors

“…The right atrium was more susceptible to MCTs, consistent with the previous Chinese study. 19) MCT patients in our group were symptomatic at the time of diagnosis, with high frequencies of dyspnea (8, 57.1%) and pericardial effusion (8, 57.1%). The latter symptom seems rare in a related study.…”

“…29) In our group, six patients suffered coronary artery mobility from tumor influence, which was considered un-usual in some reports; 30,31) some studies based on Asian populations also lack information on the percentage of coronary artery involvement. 19,32) They complained of increased chest pain after physical activity, a common manifestation among coronary artery patients. 33) Therefore, this indication seen in MCT patients suggest the coronary artery may be involved.…”

Echocardiography and Newer Imaging Techniques in Diagnosis and Long-Term Follow-Up of Primary Heart Tumors in Children

“…The most dangerous traits are obstructions in intracardiac blood flow and peripheral embolization. According to Yin et al [ 18 ], blood flow-obstructing stenoses were diagnosed in 60–70% of adult patients affected by heart tumors, and stenocardial pain and loss of consciousness were the main clinical symptoms. Embolization was found in 21.5% of cases.…”

“…In the case of malignant tumors, the prognosis is dramatically worse. Such tumors appear in 5% of cases and constitute 15–16% of all tumors requiring operational treatment [ 7 , 17 , 18 ]. The worst prognoses are in the cases of rhabdomyosarcoma and mesothelioma.…”

Primary leiomyosarcoma of the atrium with heterologous differentiation

“… 1 Among all cardiac tumors, only 20.6% are malignant. 2 Malignant neoplasms are usually highly aggressive, locally invasive sarcomas with an invariably fatal outcome. The most common site is the left atrium in approximately 75% of all cases.…”