Key result
Surgical resection of primary cardiac tumors, which were predominantly benign myxomas, resulted in a 2.4% operative mortality and a 2.4% recurrence rate over a 1-year follow-up.
Why the study?
Cardiac tumors are rare and challenging to diagnose, with the evidence base for management derived mostly from case reports or small case series.
Cohort (n=82)
Yes
Surgical resection of primary cardiac tumors is feasible and safe for benign tumors, but malignant tumors remain challenging with higher risks of recurrence and mortality.
Supports resection safety in cardiac myxomas; cohort data leave open need for prospective confirmation.
Background Cardiac tumors are rare, and their diagnosis is challenging. The level of evidence for the management of cardiac tumors came from case reports or small case series. We aim to present our multicenter experience in the diagnosis and management of cardiac tumors. Results We performed a prospective study, including 82 cases of cardiac tumors encountered at three centers in 5 years. The mean age was 62 ± 5.8 years old (range 2 months–74 years), and 91.4% were females constituted. The median EuroSCORE II was 4.27%. All cases underwent radical excision of the tumor. Five cases underwent additional mitral valve replacement and one case underwent coronary bypass grafting. Pathological diagnoses were left atrial myxomas ( n = 65, 79.3%), right atrial myxomas ( n = 5, 6.1%), bi-atrial myxomas ( n = 2, 2.4%), right ventricular outflow tract myxoma ( n = 1, 1.2%), myxosarcoma ( n = 1, 1.2%), thymoma ( n = 1, 1.2%), recurrent hemangioendothelioma ( n = 1, 1.2%), round cell tumor ( n = 1, 1.2%), cardiac lymphoma ( n = 1, 1.2%), rhabdomyomas ( n = 2, 2.4%), and renal cell carcinomas ( n = 2, 2.4%). Two patients (2.4%) had re-exploration for bleeding. One patient (1.2%) with right atrial thymoma experienced a severe vasoplegia with unstable hemodynamics. Two patients had operative mortality (2.4%), one with recurrent cardiac hemangioendothelioma. During 1-year follow-up, one patient (1.2%) died because of metastatic myosarcoma. Recurrence was reported in 2 patients (2.4%). Conclusions The clinical scenario of cardiac tumors depends mainly on tumor location and size rather than the histopathology. Surgical resection is feasible in benign tumors while very challenging in malignant tumors.
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Sanad et al. (2020) conducted a cohort in Primary cardiac tumors (n=82). Surgical resection was evaluated on Postoperative morbidity and mortality. Surgical resection of primary cardiac tumors, which were predominantly benign myxomas, resulted in a 2.4% operative mortality and a 2.4% recurrence rate over a 1-year follow-up.
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