Surgical treatment of rare pediatric cardiac myxomas:12 years clinical experience in a single institution

Abstract

Background Primary cardiac tumors are very rare, especially in children. Cardiac myxomas(CM) constitute the major proportion among these masses.Most of the reports in the literature are case reports.This study summarizes our 12-year clinical experience with surgical treatment of CM. Methods We retrospectively analyzed the clinical data of 23 children with CM(8 boys, 15 girls; median age: 8.92 months, range: 2 years 5 months-12 years 9 months; body weight: 11kg-45kg, median body weight: 28.21kg) admitted to our hospital in the previous 12 years, and we statistically analyzed their clinical manifestations and surgical methods. Results 23 cases underwent myxoma excision under cardiopulmonary bypass(CPB), 16 cases directly underwent foramen ovale suture closure, 7 cases underwent pericardial patch repair due to large atrial septal defect, 3 cases underwent mitral valve repair, and 2 cases underwent tricuspid annulus contraction.The postoperative course was uneventful in most patients. A few patients had some complications.There were 8 cases of postoperative arrhythmia and 4 cases of postoperative low cardiac output syndrome.23 cases were followed up for 0.2 to 12.6 years, and 1 case with cerebral infarction combined with hemiplegia of the right limb recovered well after rehabilitation treatment.The 22 children had no cerebral embolism, acute heart failure, atrioventricular block and other related complications.There was no recurrence of CM in 22 cases, and all recovered after surgery.One patient recurred 5 years after the operation, and no tumour recurrence was observed after the second operation.One patient (4.35%) died due to myocardial infarction in early postoperative period with persistent low cardiac output. Conclusions Although CM in children is rare, it may cause cerebral infarction and other multi-organ embolism.Once CM is found, it must be surgically removed as soon as possible, which can not only reduce serious complications, but also has the possibility of curing.If the complete resection is possible, surgery provides better palliation and can possibly double survival.Follow-up echocardiographic should be paid attention to after surgery.