Cardiac tumors surgery

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

## Overview

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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.

## Surgery

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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]

## References

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1. ↑ 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.
2. ↑ 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.CS1 maint: Multiple names: authors list (link)
3. ↑ 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.CS1 maint: Multiple names: authors list (link)

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