PRIMARY CARDIAC TUMORS: 5 YEARS OF EXPERIENCE IN SEYED-AL-SHOHADA CARDIOVASCULAR CENTER, URMIA, IRAN

Primary cardiac tumors are rare entities with an autopsy frequency ranging between 0.017% and 0.19%. The present study aimed to summerize 5 years of our clinical experience with surgical resection of intracardiac tumors.
In this study, 3245 consecutive cases of cardiac operations performed at Seyed-al-Shohada Cardiovascular Center between November 2009 and December 2014 were retrospectively reviewd. The data of 13 patients with open heart surgery due to cardiac tumors were selected and analyzed. All patients underwent median sternotomy and cardiopulmonary bypass.
The prevalence of cardiac operations for primary cardiac tumors was 0.4% among the corresponding period cardiac operations. Of 13 operated patients, 6 were female (46.2%) and 7 male (53.8%). The average age of the patients was 15 to 82 (mean 55.1 ± 16.2). The typical presentations were cardioembolic stroke in 30.8% and congestive symptoms in 46.2%. It was an incidental finding in 23% of cases (3 patients). Myxoma (84.6%) was the most common diagnosis, typically affecting the left atrium (81.8%). Malignant tumors represented 7.7% of cases. Mean tumor dimension was 5.2 cm in largest diameter. Three patients (23%) had concommitant surgery together with tumor resection. Papillary myxoma was found in 54.5% of patients (6 of 11 myxoma) and strongly was associated with preoperative cardioembolic stroke (CVA). There were no early hospital deaths in the perioperative period, and follow-up ranged from 6 to 44 months (mean23 months). Only one patient died during follow-up after 2 years of surgery for malignant tumor. None of the myxoma patients had tumour recurrence. At the last follow-up examination, all of patients were in functional NYHA classes I or II.
Surgical resection provides excellent outcome in patients with benign cardiac tumors and surgery for cardiac myxoma is associated with low long-term mortality and morbidity. Malignant tumors are a challenge despite good local tumor control because local recurrence and metastatic disease lead to limited survival.