Surgical management of cardiac tumors

Abstract

Cardiac tumors, though rare, can affect all parts of the heart, from venous structures to atria to ventricles, valves, and great vessels. Although most are benign and have good long-term prognosis, surgery for malignant tumors, whether primary or secondary, usually carries poor long-term survival. Surgery follows examination by 2D echo, CT, MRI, and possibly coronary angiography. Whenever malignancy is suspected, metastatic workup is required before primary resection and reconstruction. Bovine pericardium, Dacron grafts, and prosthetic valves are used for reconstruction. Resection of ventricular tumors is limited by lack of a good ventricular muscular replacement. Although cardiac transplantation has been used for tumors, long-term survival for anything but benign tumors is limited, making transplant a poor solution for any malignant tumors. Outcome of resection of heart or great vessel tissue for tumors arising elsewhere is related more to the primary tumor than it is to the cardiac resection and reconstruction.