Cardiac tumors: About 100 cases

Abstract

Cases of cardiac tumours including primitives described in the literature remains infrequent compared to metastatic one (secondary tumours). Frequency: 0.001% and 0.28%. The diagnosis becomes increasingly early by dint of modern imaging advent, which facilitated curative surgery and a better prognosis particularly for benign tumours. Bring the experience of our service centre in the management of cardiac tumours, their clinical presentation, treatment modalities, morbidity and mortality and recurrences frequency. During the period of: January 2000–December 2015, 100 patients underwent open heart surgery for cardiac tumour. Thirty-five men and 65 women. The average age: 48.79 years with extremes (5–77 years). The symptomatology is dominated by dyspnea (71% are patients with stage II–III NYHA). Palpitations, fainting/syncope, or embolic complications. The trans-thoracic echocardiographic confirms the diagnosis in all cases. In some cases: a chest CT. Surgical excision with cardiopulmonary bypass (CPB), in 12 patients (without clamping). Surgical expertise specified: the type–nature of the tumour. In total, 92% of benign tumours (70% are myxomas). The preferred seat is the left atrium (67 patients). Pathological forms: – 01 polymorphic poorly differentiated sarcoma; – 02 Fibrosarcoma; – 01 embryonal rhabdomyosarcoma (girl of 05 years); – Kaposi 01; – 01 angiosarcoma; – 02 non-Hodgkin's lymphoma. Total operative mortality: 6% (06 patients). Immediate complications: conduction disorder in 2 patients. The average follow-up: between 1 month to 7 years. Late deaths (03%) due to extra cardiac causes. Three recurrences: 2 for myxoma, one for fibrosarcoma. By cons, there was a very good evolution in the patient with non-Hodgkin lymphoma. Thanks to modern imaging advent, diagnosis can be early before the onset of serious complications; if only one clinically suspicious. The prognosis of benign cardiac tumours depends on the quality of surgical treatment. Surgery gives very good immediate and remote insisting on a periodic and regular monitoring; by cons for malignant tumours, it remains worse and depends on early in the surgical management, which is not hollowing since become symptomatic tumours are not at an advanced stage, in addition requires good protocols codified for these very rare and also very serious tumours ( Fig. 1 ).