Retrospective analysis of 11 cases of primary cardiac valve tumors

Abstract

Objective: To explore the clinical features and surgical treatment experience of primary cardiac valve tumor.

Methods: The present study retrospectively analyzed the clinical data of 11 patients with primary valvular tumors who underwent surgical treatment in our department from 1980 to 2016. Echocardiography of preoperative patients was indicated as a heart valve tumor. All patients underwent cardiopulmonary bypass surgery after endocardial angiography and positron emission tomography-computed tomography diagnosis, including four tumor resections-valvuloplasty and seven tumor resections-heart valve replacement. Pathological analysis was performed on all tumors. Postoperative cardiac ultrasound was followed up. Pathological analysis was performed on all tumors. All patients underwent postoperative ultrasound follow-up examination.

Results: Primary valvular tumors are rare, accounting for only 0.034% (11/32.728) of extracorporeal circulation surgery in our center. It accounts for 2.8% (11/399) of primary cardiac tumors in the same period. Pathological study indicated that there were 10 cases of benign tumor and 1 case of low-grade sarcoma. After 0.6-16 years of follow-up, the operation effect was satisfactory.

Conclusion: Most of these tumors are papillary fibroelastoma located on the mitral valve, and surgical operation is the best strategy for cardiac primary valve tumors.

Figure 1

A representative data of primary cardiac valve tumor (case 4). (a) A light red elliptical neoplasm resected at anterior mitral valve (approx. 1.0×0.8×0.4 cm³). (b) Hematoxylin and eosin staining of rhabdomyoma (100×). The tumor is composed of polygonal muscle cells mixed with spindle-shaped cells–spider web formed

Figure 2

A representative data of patient with primary cardiac valve tumor (case 9). (a) Cardiac ultrasound. The arrow indicates large mitral valve tumor attaching to the posterior mitral valve. (b) Resected mitral valve and tumor (approx. 6×4.0×2.5 cm³). The arrow indicates the posterior mitral valve

Figure 3

A representative data of patient with primary cardiac valve tumor (case 8). (a) Cardiac ultrasound. The arrow indicates large pulmonary valve tumor blocking the right ventricular outflow tract. (b) Resected tumor (10×5.5×4.5 cm³) growing from the pulmonary valve. The arrow indicates the pulmonary valve

Figure 4

Intracardiac contrast echocardiography. (a) Before injection of contrast. The arrow indicates the mitral valve and the attached neoplasia. (b) After injection of contrast. In LVO contrast mode, the contrast develops in each cardiac chamber in sequence. The arrow indicates basically synchronous developing of mitral valve neoplasia and ventricular muscle