Patients with intracardiac masses: 12-year observation from a tertiary referral hospital

Aim: Intracardiac masses are extremely rare and challenging to manage. Due to the rarity of the disease and the absence of data from large randomized clinical trials, recommendations for the diagnosis and management of intracardiac masses are still derived from expert opinion and observational cohort studies. In this study we aim to describe the epidemiological features, clinical characteristics, and prevalence of intracardiac masses. Material and Methods: The records of 133 patients aged >18 who underwent open surgery due to confirmed intracardiac masses were investigated retrospectively. Demographic and clinical characteristics of the patients, the indication for the procedure, and postoperative outcomes were retrospectively analyzed. For isolated intracardiac masses, the mass location, final histopathologic diagnosis, concomitant clinical conditions, and preferred surgical approach were analyzed. Results: The most common histopathologic diagnosis was atrial myxoma (n=62, 46.6%), followed by cardiac thrombus (n=33, 24.8%), and the most common location of the intracardiac masses was the left interatrial septum (n=48, 36.1%). The composite of all-cause mortality was the most common early outcome (n=11, 8.3%) while tumor-related mortality was the most common late outcome (n=15, 11.3%). Discussion: Our data show that intracardiac masses have diverse etiology and various clinical manifestations, and they often require cardiac surgery. In order to prevent complications, careful assessment and optimal timing of surgery is mandatory.