[Diagnosis and surgical management of primary cardiac neoplasms]

Abstract

Objective: To review and summarize the experience in diagnosis and surgical management of primary cardiac neoplasms.

Methods: 112 patients with primary cardiac neoplasms were treated surgically from Jan. 1980 to Jan. 2005. Those tumors were grouped into three categories: myxomas (98), benign nonmyxomas (3), and malignant tumors (11). Five of 11 malignant tumor patients underwent biopsy or palliative operation, the other patients received complete excision. Mitral valve replacement were done simultaneously in 2 of these patients, mitral valve repair in 4 and tricuspid valvoplasty in 33. All patients' diagnosis was confirmed by echocardiography.

Results: 108 patients survived the operation and 4 patients died postoperatively. The hospital mortality was 3.6% (4/112). Two patients developed poor left ventricular function postoperatively and died at the third and the seventh postoperative day due to low cardiac output. One patient developed and died of progressive hepatic and renal function failure postoperatively. Another one patient died of severe arrhythmia. Mean follow-up of 76 myxoma patients who are still alive was 6.4 years (range, 3 month to 17 years). Fifty-five patients still had heart function in New York Heart Association class I and 21 in class II at the end of follow-up without any evidence of recurrance. The follow-up results of benign nonmyxomas were similar to those of myxomas. Mean follow-up of all survived malignant tumor patient was 6 months (range, 2 months to 12 months). Ten of them died of recurrence or metastasis within 1 year postoperatively except only one still alive.

Conclusion: Surgical resection, whenever possible, is the first treatment choice for all kinds of primary cardiac tumors. Surgical resection of myxoma and benign nonmyxoma can give excellent long-term results which may lead to eventual cure of myxoma and benign nonmyxoma. For malignant tumor patient, surgical treatment is only palliative and to prolong the life of patients.