56 Years of Experience of Primary Tumors of The Heart

Abstract

22 large autopsy series reported by Mc Allister et al [1]. showed the frequency of primary cardiac tumors is ∼0.02%, corresponding to 200 tumors in 1 million autopsies. Around 75% are benign; nearly half are myxomas; and a majority of the rest are lipomas, papillary fibroelastomas, and rhabdomyomas [1]. Sixty years ago in 1954, Crafoord [2] was the first to excise an atrial myxoma on cardiopulmonary bypass [2]. Today, cardiac tumors represent around 0.3% of all open-heart surgeries [3]. From 1963 to 2019 7,600 open Heart operations were done in ouers diferents centers in Argentina. 23 Patients (0.3%) were operated on of primary Tumor of the heart. In this report, we review the surgical experience and results of cardiac tumors during this 56 years. Material and Methods 15 patients were female (65%) The average age was 52 years (1967) The clinical presentation was Dyspnea 8 (34,8%) Arrtymia 6 (26,08%) ChestPain 3 (13%), Emboli 2 (8,7%), Syncope 2 (8,7%), Accidentaly 2(8,7%). 17 were Myxomas 17 cases (74%) 15 (88%) left and 2 (12%) rigth. Papillary Fibroelastoma 4 (17,4%) sarcoma 1 (4,4%) Cyst 1(4,4%) Surgical Thecnique: all of the patients in this serie were operated on with Cardiopulmonary Byapass 21 througth Sternotomy and 2 Minimally invasive Rigth Thoracotomy. In 20 patients the tumor was excised under direct visión with and without magnification. In 3 patients Video 3 D was used to improved the visualization during the operation. ResultsThe operative mortality was 1 case (4,3%). The patient with a Sarcoma died inmediatly after the operation; the entire Rigth Ventricle was invaded by the Tumor the exsicion was very dificult.The rest of the patients survived the operation At the average of 29,8 years of follow up of the 17 patients with Myxmomas 6 (35%) died ,no recurrence of the Tumor were found in this patients. In the patients with Papillary Fibroelastoma 2 patients were lost of follow up one died at 12 years after de operation and the other is alive The patient withCyst died at 8 years after the operation.