Cardiac tumors surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dheeraj Makkar, M.D.[2]

Overview

Surgery may be an option in specific cases of malignant tumors.

Patients with solitary heart illness and a managed primary tumor are optimal.
The tumor must be amenable to resection while maintaining adequate heart function to support life.

Whether malignant or benign, clinical signs determine the criteria for emergency surgery.

Cardiac tumors can generate a wide range of symptoms, including the four indications for surgery:
- Restriction of intracardiac blood circulation or interference with valve function
- Rhythm abnormalities or pericardial effusions with tamponade owing to local penetration
- Embolization, resulting in systemic or pulmonary impairments
- Systemic or constitutional symptoms resulting from the tumors

Surgical Treatment of Cardiac Tumors
Tumor	Treatment
Myxoma	Total excision Surgical intervention is necessary for patients with severe dyspnea or a significant risk of embolism. Surgical mortality rate of less than 5% 2% to 5% of patients are at risk for recurrence^[1]
Papillary Fibroelastomas	Surgical resection with reconstruction, Less often, valve replacement. ^[1]
Cardiac Rhabdomyoma	Therapeutic resection of the problem portion of the lesion^[1]
Cardiac Fibroma	Complete excision/ Palliative partial resection^[1]
Teratoma	Fetal Tumor Excision or Immediate surgery after Cesarian section^[1]
Cardiac Lipoma	Complete Tumor resection^[1]
Hemangioma	Conservative in asymptomatic Radical Resection in symptomatic^[1]
Hamartomas	Surgical Resection^[1]

Papillary Fibroelastoma

Surgery is the mainstay of therapy for papillary fibroelastoma.
Surgical excision is generally recommended among patients with papillary fibroelastoma (for symptomatic relief).
A minimally invasive approach may be possible if the tumor involves the aortic valveor right atrium.^[2]
In the case of aortic valve involvement, excision of the tumor is often valve-sparing, meaning that replacement of the valve with a prosthetic valve is not necessary. Repair of the native valve with a pericardial patch has been described.^[3]

↑ ^1.0 ^1.1 ^1.2 ^1.3 ^1.4 ^1.5 ^1.6 ^1.7 Lamba G, Frishman WH (2012). “Cardiac and pericardial tumors”. Cardiol Rev. 20 (5): 237–52. doi:10.1097/CRD.0b013e31825603e7. PMID 22447042.
↑ Kim RW, Jeffery ME, Smith MJ, Wilensky RL, Woo EY, Woo YJ. (2007). “Minimally invasive resection of papillary fibroelastoma in a high-risk patient”. J Cardiovasc Med (Hagerstown). 8 (8): 639–41. PMID 17667039.
↑ Westhof FB, Chryssagis K, Liangos A, Batz G, Diegeler A. (2007). “Aortic valve leaflet reconstruction after excision of a papillary fibroelastoma using autologous pericardium”. Thorac Cardiovasc Surg. 55 (3): 204–7. PMID 17410513.