Incidence and clinical importance of cardiac tumors in China--review of the literature

Abstract

The first successful excision of a left atrial myxoma in China was performed in 1962. Till October 1988, 656 surgical cases of cardiac tumors have been reported in the Chinese literature. The diagnosis of all excised tumors was confirmed by pathologic studies. The age of patients ranged from 46 days to 72 years. Among these 656 cases, 647 tumors were benign (97%) and 9 tumors were malignant (3%). 633 myxomas (97.8%) represented the vast majority of the benign cardiac tumors. In 26 cases, myxomas were found multilocalized. Before 1975, echocardiography could not be performed universally in our country, and diagnosis often failed. At present, echocardiography is the most used and the most reliable examination method for cardiac tumors in China. The majority of the patients presented clinical symptoms of congestive heart failure with palpitation, dyspnoe, syncope, and hemoptysis. In 99% the main abnormality was an atypical and frequently variable heart murmur. Arterial embolization occurred in 15%. In all patients the myxomas was removed as a whole with its attachment to the interatrial septum or the atrial wall to prevent recurrence. Examination of all heart chambers should be performed to exclude multilocalized tumors. The operative mortality ranged between 5.8 to 13%. The recurrence rate of myxomas in China was reported to amount to 3%.