Outcomes after surgical resection of primary non-myxoma cardiac tumors

Abstract Objective: Primary cardiac tumors are rare lesions with different histological type. We reviewed our 17 years of experience in the surgical treatment and clinical results of primary non-myxoma cardiac tumors. Methods: Between July 2000 and February 2017, 21 patients with primary cardiac tumor were surgically treated in our institution. The tumors were categorized as benign non-myxomas and malignants. Data including the demographic characteristics, details of the tumor histology and grading, cardiac medical and surgical history, surgical procedure of the patients were obtained from the hospital database. Results: Eleven patients were diagnosed with benign non-myxoma tumor (male/female:7/4), ranging in age from 10 days to 74 years (mean age 30.9±26.5 years). Papillary fibroelastoma was the most frequent type (63.6%). There were two early deaths in benign group (all were rhabdomyoma), and mortality rate was 18%. The mean follow-up period was 69.3±58.7 months (range, 3 to 178 months). All survivals in benign group were free of tumor-related symptoms and tumor relapses. Ten patients were diagnosed with malignant tumor (sarcoma/lymphoma:8/2, male/female:3/7), ranging in age from 14 years to 73 years (mean age 44.7±18.9 years). Total resection could be done in only three (30%) patients. The mean follow-up period was 18.7±24.8 months (range, 0-78 months). Six patients died in the first 10 months. Conclusion: Complete resection of the cardiac tumors, whenever possible, is the main goal of surgery. Surgical resection of benign cardiac tumors is safe, usually curative and provides excellent long-term prognosis. On the contrary, malignant cardiac tumors still remain highly lethal.

Resection of left atrial myxoma in a patient with retrosternal gastric tube: a case report

Abstract The median sternotomy remains the standard approach in cardiovascular surgery but, in some conditions, it can be considered difficult to perform, especially in patients with history of esophagectomy. This case report describes a successful resection of a left atrial myxoma through a right anterolateral thoracotomy approach in a patient with a previous retrosternal gastric tube reconstruction. The decision for the best surgical approach was made after a heart surgery team discussion. Through this surgical access, a safe and excellent exposure of the left atrium was possible, and a complete resection of the myxoma was performed without any injury to the gastric tube.

Resultados quirúrgicos y seguimiento postoperatorio de mixomas auriculares / Surgical results and monitoring of postoperative atrial myxomas

Resumen: Objetivo: Analizar la casuística del mixoma auricular izquierdo, haciendo énfasis en los resultados y seguimiento. Método: Se revisaron los expedientes clínicos de los pacientes operados de mixomas cardiacos en el Hospital Central Sur de Alta Especialidad (HCSAE) de PEMEX en los últimos 7 años, haciendo hincapié en los resultados y seguimiento. Resultados: El análisis mostró 10 pacientes, de los cuales el 60% fueron mujeres y el 40% varones; las edades fueron de los 12 a los 76 años, con una edad media de 50 años. En las características clínicas de los pacientes predominó la disnea en un 90%, seguido de la fatiga (80%) y dolor torácico (60%). La incidencia fue del 90% para la aurícula izquierda y del 10% en aurícula derecha, hubo tumores de menos de 3 cm hasta mayores de 10 cm (media de 6-7 cm). El informe de patología fue de mixoma en el 100% de los casos, La morbimortalidad temprana fue del 0%, con una estancia hospitalaria promedio de 6 días; una paciente de 12 años tuvo una recidiva y se sometió otra vez a cirugía 5 meses más tarde. La supervivencia a 5 años es del 100%. Conclusiones: Se sabe que la presentación de Mixomas es muy poco frecuente, la experiencia en este Centro de Concentración Nacional, es de un paciente por cada 350 cirugías, en promedio un caso por año con una nula mortalidad y una excelente supervivencia.

Abstract: Objective: To analyze the casuistics of left atrial myxoma with emphasis on results and follow-up. Method: We reviewed the clinical records of patients operated in the Hospital Cardiac Myxomas South Central High Specialty (HCSAE) of PEMEX in the last 7 years, with an emphasis on results and follow-up. Results: The analysis showed 10 patients, of whom 60% were female and 40% male, with ages from 12 to 76 years, with a mean age of 50 years. In the clinical characteristics of patients predominated dyspnea in 90%, followed by fatigue (80%) and chest pain (60%). The incidence was 90% for the left atrium and 10% for the right atrium, had tumors less than 3 cm to up to over 10 cm (average of 6 to 7 cm). The pathology report was myxoma in the 100% of cases, the morbidity and early mortality was 0%, with a mean hospital stay of 6 days, and a patient of 12 years of age recurred and underwent surgery five months later. The 5-year survival was 100%. Conclusions: The incidence of myxomas is well known for rare presentation, the experience in this national medical center is one patient for every 350 operations, one case per year with no mortality and excellent survival.

Fibroelastoma valvular aórtico como causa de accidente cerebrovascular embólico: reporte de un caso / Aortic valve fibroelastoma as a cause of an embolic cerebrovascular accident: a case report

Los tumores cardíacos son una causa rara de accidente cerebrovascular embólico. Comunicamos el caso de una paciente de 65 años quien debuta su historia con un accidente cerebrovascular. El estudio de fuente embólica con ecocardiografía transesofágica demostró un fibroelastoma de la válvula aórtica en el borde libre del velo no coronariano. El tumor fue extraído mediante circulación extracorpórea. El estudio anatomopatológico confirmó el diagnóstico y la paciente se encuentra en capacidad funcional I y sin síntomas neurológicos a 19 meses de seguimiento.

Background: Cardiac tumors are an infrequent cause of an embolic source and aortic fibroelastoma is even more rare as causative of a stroke. We report a 65 year old female with no particular clinical history admitted to the hospital with an embolic cerebrovascular accident whose embolic source study with a transesophageal echocardiogram revealed a fibroelastoma in the free edge of the non coronarian leaflet of the aortic valve. The patient was subjected to surgery by means of extracorporeal circulation and the tumor was excised. The pathological study confirmed the diagnosis. Post operative recovery was uneventful with no neurological damage and after 19 months of follow up she is in functional class I.

Mixoma de átrio esquerdo associado a derrame pleural / Left atrial myxoma associated with pleural effusion

Homem de 65 anos apresentando emagrecimento, dispnÚia e derrame pleural (DP) recorrente. A avaliaçäo cardiológica evidenciou ruflar diastólico (3/6) no foco mitral e hiperfonese da 1ª bulha. O ecocardiograma e o estudo hemodinâmico mostraram uma grande massa tumoral no átrio esquerdo (AE), sugerindo mixoma e hipertensäo pulmonar. A biópsia pleural revelou pleurite crônica inespecífica. O paciente foi submetido à operaçäo com circulaçäo extracorpórea para exérese do tumor de AE e o estudo histopatológico confirmou o diagnóstico de mixoma. O DP tem sido manifestaçäo muito rara do mixoma cardíaco (MC), que às vezes apresenta somente sinais e sintomas inespecíficos de doença inflamatória crônica