Peculiarities of tactics of surgical treatment of primary benigh heart tumours
The frequency of diagnosing primary heart tumours (PHT), of which more than 80% are morphologically benign tumours, ranges from 0.09% to 1.9% of the total number of hospitalized patients. In the structure of cardiac neoplasms, myxoma constitute 80-90% of benign heart tumours.
The objective of the study is to determine the peculiarities of tactics оf diagnosis and surgical treatment of primary heart tumours.
Material and methods. 939 patients underwent surgical interventions for primary cardiac tumours in M.M. Amosov Institute of Cardiovascular Surgery of the Academy of Medical Sciences of Ukraine for the period from January 1, 1969 to January 1, 2019. Cardiac myxomas (CM) were diagnosed in 838 (89.2%) patients, of which left atrial (LA) CM – in 738 (88.1%) cases. The right atrial (RA) myxomas were diagnosed in 73 (8.7%) cases, left ventricular (LV) and right ventricular (RV) CM – in 8 (1.0%) cases, respectively. Multicentric tumour growth with damage to two or three cardiac chambers was found in 11 (1.3%) patients. The age of patients with CM was from 3 to 78 years (on average 47.5± 3.4), the age of 608 (72.5%) patients ranged from 31 to 60 years. Non-myxomic benign tumours were observed in 35 (3.7%) cases, malignant tumours – in 66 (7.0%) cases.
Results and discussion. 304 (36.3%) and 71 (8.5%) patients had NYHA classes III and IV, respectively, which often required urgent surgical treatment in these groups. Hospital mortality over the past 18 years was 0% in CM surgical treatment, namely, 475 operations were performed without lethal outcomes.
Conclusions. The accepted tactics of urgent diagnosis and surgical intervention ensure the efficacy of cardiac myxoma treatment, as evidenced by long-term findings: 626 (78.4%) patients had NYHA class I, 118 (14.6%) patients had NYHA class II respectively. 20-year survival rate was observed in 79.8% cases.
- Anvari MS, Naderan M et al. Clinicopathologic Review of Non-Myxoma Cardiac Tumors: A 10-Year Single-Center Experience. Cardiology. 2014;129:199–202.
- Vitovskiy R, Isaienko V et al. The Tactics of Safe Removal of Heart Myxomas; The Experience of 796 Operations. E Journal of Cardiovascular Medicine 2018;06(2):56–59. https://doi.org/10.15511/ejcm.18.00256
- Hoffmeier A, Sindermann JR, Scheld HH et al. Cardiac tumors-diagnosis and surgical treatment. Deutsches Ärzteblatt International. 2014;111(12):205–11.
- Habertheuer A, Laufer G, Wiedemann D. et al. Primary cardiac tumors on the verge of oblivion: a European experience over 15 years. J Cardiothorac Surg. 2015; 10:56–60.
- Isogai T, Yasunaga H, Matsui H. et al. Factors affecting in-hospital mortality and likelihood of undergoing surgical resection in patients with primary cardiac tumors. J Cardiol. 2016;10:1016.