ObjectiveTo summarize the age distribution of different pathological types of primary left ventricular tumor and its influence on preoperative diagnosis, surgical methods and therapeutic effect.Methods The clinical data of 35 patients with primary left ventricular tumor admitted to Fuwai Hospital of Chinese Academy of Medical Sciences from January 2008 to March 2019 were retrospectively analyzed. There were 19 males and 16 females with an average age of 33.81±17.56 years. According to the age, the patients were divided into an infant group (less than 7 years), an adolescent group (7-17 years), a young group (18-44 years), a middle-aged group (45-59 years) and an elderly group (over 60 years). The age distribution characteristics of different pathological types of tumor patients were analyzed, and the influence on surgical methods, short-term and long-term curative effect of surgery in different age groups was analyzed. Within 6 months after the operation, the patients returned to the hospital to review the echocardiography, and then were followed up by telephone.Results Of the 35 patients with primary left ventricular tumor, only 1 patient in the middle-aged group had low malignancy carcinoid tumor, and the others were benign tumors. Fibroma and rhabdomyoma accounted for the majority of the infant group and adolescent group. Myxoma was the common tumor in the young group, middle-aged group and elderly group, followed by lipoma. Thirty-three patients were operated under general anesthesia, hypothermia and cardiopulmonary bypass (CPB). Two patients with epicardial lipoma underwent normothermic surgery without CPB. Nine patients underwent partial resection of left ventricular tumors, and 26 patients received complete resection of left ventricular tumor. There was no hospital death, opening stanching, secondary thoracotomy, low cardiac output, embolism or other complications. The postoperative hospital stay was 7.97±2.56 days, and the postoperative reexamination was normal. Subsequently, 35 patients were followed up by telephone or outpatient service. The average follow-up time was 59.87±37.62 months. In the young group, 2 patients with partial resection recurred.Conclusion Surgical resection is the first choice for the treatment of left ventricular benign tumor, and it is safe. The principle of left ventricular tumor surgery is to protect the function of ventricle and valve, prevent damage to the conduction system, and remove the tumor as completely as possible.
Objective To share clinical experience of minimally invasive technique in surgical treatment of cardiac tumors. Methods Clinical data of 50 patients with cardiac tumors who underwent surgical teatment in Zhongshan Hospital of Fudan University from January 2011 to September 2014 were analyzed retrospectively. There were 18 males and 32 females aged from 32 to 65 years (mean age 47 years). Cardiac tumors were located in the left atrium in 44 (88%) patients and right atrium in 6 (12%) patients. Results There was no in-hospital death. All patients recovered well without any complications. Mean total operating, cardiopulmonary bypass and aortic cross-clamp time was 148±45 min, 56±23 min, 26±16 min, respectively. The average time to extubation was 5±3 hours and the median length of stay in the intensive care unit (ICU) and in the hospital was 9±6 hours and 5±3 days, respectively. All patients were followed up for 1 to 44 months without tumor recurrence except one. Conclusion Minimally invasive technique in surgical treatment of cardiac tumors via right anterolateral thoracotomy is a safe and feasible method with good cosmetic results and rapid postoperative recovery, and is worthy of clinical selective application for treatment of benign cardiac tumor.
Primary cardiac tumors, which originate from the heart, are uncommon and can be classified as benign or malignant, with the majority being benign. Malignant primary cardiac tumors have a poor prognosis. Benign ones may also cause severe hemodynamic and electrophysiological consequences, but the prognosis is generally good if they are detected early and treated properly. In recent years, researches on the genetic and molecular causes of primary cardiac tumors have yielded some promising breakthroughs, with some of them already being translated into clinical practice. This article reviews research progress and its use in precise diagnosis and targeted therapy from the perspective of DNA, RNA, and protein changes, as well as prospects the promising research directions in the future.
ObjectiveTo analyze the short-term outcomes of cardiac surgery via minimally invasive approach under thoracoscope in a single-center. Methods The clinical data of patients who underwent cardiac surgery via minimally invasive approach under thoracoscope between July 2017 and February 2022 were retrospectively analyzed. Results A total of 453 patients were enrolled, including 150 males and 303 females at an average age of 42.2±14.6 years. The main disease types included atrial septal defect in 314 patients, partial atrioventricular septal defect in 26 patients, and cardiac tumor in 105 patients. There was no death during the perioperative period. The mean operative time was 3.9±0.8 h, cardiopulmonary bypass time was 101.2±34.0 min, aortic occlusion time was 42.1±25.1 min, ventilator assistance time was 11.6±9.4 h, ICU stay time was 22.6±13.9 h and postoperative hospital stay was 6.0±1.7 d. Intraoperative and postoperative complications occurred in 18 (4.0%) patients, including 2 patients with conversion to sternotomy, 3 with incision expand, 3 with reoperation for bleeding, 1 with of redo operation, 4 with incision infection, 2 with respiratory insufficiency, 2 with cerebrovascular accident, and 1 with ventricular fibrillation. The follow-up time was 22.6±15.4 months, during which 1 patient died, 4 patients had moderate mitral regurgitation, 1 patient had mild-moderate mitral regurgitation, and 1 patient had mild-moderate tricuspid regurgitation. Conclusion Minimally invasive cardiac surgery under thoracoscope is safe with small invasions and few complications, and has satisfactory short-term outcomes.
ObjectiveTo analyze the clinical characteristics and surgical treatment results of cardiac tumors.MethodsClinical data of 28 patients with cardiac tumors, who underwent cardiac surgery in our hospital from 2013 to 2019 were retrospectively reviewed. There were 12 males and 16 females. The median age was 11.5 years, ranging 1 month to 69 years; and the median weight was 39.0 (4.8-100.0) kg. All patients underwent tumor resection under cardiopulmonary bypass with general anesthesia, and postoperative pathological analysis was performed.ResultsThere were 27 patients with primary cardiac tumors and 1 patient with secondary cardiac tumor. Among the primary cardiac tumors, there were 16 myxomas, 5 rhabdomyomas, 3 inflammatory myofibroblastomas, 2 fibroids and 2 hemangiomas. The secondary cardiac tumor was chondrosarcoma. A total of 28 cardiac tumors occurred in 29 locations, including 14 in the left atrium, 3 in the right atrium, 1 in the left ventricle, 7 in the right ventricle, 2 in the mitral and 2 in the tricuspid. Cerebral embolism occurred in 6 patients, peripheral vascular embolism in 3 patients, and syncope in 3 patients. There was no death during the perioperative period and in the long term follow-up. Complete resection was performed in 25 patients and partial resection was performed in 3 patients. During the follow-up, 2 patients with myxoma received reoperation for recurrence. Among the 3 patients with partial resection, residual tumor tissue disappeared in 2 patients, and in the other patient, there was no change in the size of the residual tumor tissue during the follow-up compared to that at discharge.ConclusionCardiac surgery is an effective method for patients with primary benign cardiac tumors. However, whether the cardiac tumor tissue can be completely removed depends on the anatomical location of the tumor during the operation. If there are systemic embolism events and syncope, the possibility of cardiac tumors should be considered.