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{{Cardiac tumors}}
{{Cardiac tumors}}
{{CMG}}; {{AE}} {{DMakkar}}
==Overview==
Surgery may be an option in specific cases of malignant tumors.
*Patients with solitary heart illness and a managed primary tumor are optimal.
*The tumor must be amenable to resection while maintaining adequate heart function to support life.


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==Surgery==
 
Whether malignant or benign, clinical signs determine the criteria for emergency surgery.
*Cardiac tumors can generate a wide range of symptoms, including the four '''indications for surgery''':
**'''Restriction of intracardiac blood circulation''' or interference with valve function
**'''Rhythm abnormalities''' or '''pericardial effusions''' with tamponade owing to local penetration
**'''Embolization''', resulting in systemic or pulmonary impairments
**'''Systemic or constitutional symptoms''' resulting from the tumors
{| class="wikitable"
|+ Surgical Treatment of Cardiac Tumors
|-
! Tumor !! Treatment
|-
|  '''[[Myxoma]]''' ||  Total excision
**Surgical intervention is necessary for patients with '''severe dyspnea or a significant risk of embolism'''.
**'''Surgical mortality rate''' of less than 5%
**2% to 5% of patients are at '''risk for recurrence<ref name="pmid22447042">{{cite journal| author=Lamba G, Frishman WH| title=Cardiac and pericardial tumors. | journal=Cardiol Rev | year= 2012 | volume= 20 | issue= 5 | pages= 237-52 | pmid=22447042 | doi=10.1097/CRD.0b013e31825603e7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22447042  }} </ref>
'''
|-
|'''[[Papillary Fibroelastomas]]'''  || Surgical resection with reconstruction,
*Less often, valve replacement. <ref name="pmid22447042">{{cite journal| author=Lamba G, Frishman WH| title=Cardiac and pericardial tumors. | journal=Cardiol Rev | year= 2012 | volume= 20 | issue= 5 | pages= 237-52 | pmid=22447042 | doi=10.1097/CRD.0b013e31825603e7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22447042  }} </ref>
 
|-
| '''[[Cardiac Rhabdomyoma]]''' || Therapeutic resection of the problem portion of the lesion<ref name="pmid22447042">{{cite journal| author=Lamba G, Frishman WH| title=Cardiac and pericardial tumors. | journal=Cardiol Rev | year= 2012 | volume= 20 | issue= 5 | pages= 237-52 | pmid=22447042 | doi=10.1097/CRD.0b013e31825603e7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22447042 }} </ref>
|-
| '''[[Cardiac Fibroma]]''' || Complete excision/ Palliative partial resection<ref name="pmid22447042">{{cite journal| author=Lamba G, Frishman WH| title=Cardiac and pericardial tumors. | journal=Cardiol Rev | year= 2012 | volume= 20 | issue= 5 | pages= 237-52 | pmid=22447042 | doi=10.1097/CRD.0b013e31825603e7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22447042  }} </ref>
|-
| '''[[Teratoma]]''' || Fetal Tumor Excision or Immediate surgery after Cesarian section<ref name="pmid22447042">{{cite journal| author=Lamba G, Frishman WH| title=Cardiac and pericardial tumors. | journal=Cardiol Rev | year= 2012 | volume= 20 | issue= 5 | pages= 237-52 | pmid=22447042 | doi=10.1097/CRD.0b013e31825603e7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22447042  }} </ref>
|-
| '''[[Cardiac Lipoma]]''' || Complete Tumor resection<ref name="pmid22447042">{{cite journal| author=Lamba G, Frishman WH| title=Cardiac and pericardial tumors. | journal=Cardiol Rev | year= 2012 | volume= 20 | issue= 5 | pages= 237-52 | pmid=22447042 | doi=10.1097/CRD.0b013e31825603e7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22447042  }} </ref>
|-
| '''[[Hemangioma]]''' || Conservative in asymptomatic
*Radical Resection in symptomatic<ref name="pmid22447042">{{cite journal| author=Lamba G, Frishman WH| title=Cardiac and pericardial tumors. | journal=Cardiol Rev | year= 2012 | volume= 20 | issue= 5 | pages= 237-52 | pmid=22447042 | doi=10.1097/CRD.0b013e31825603e7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22447042 }} </ref>
|-
| '''[[Hamartomas]]''' || Surgical Resection<ref name="pmid22447042">{{cite journal| author=Lamba G, Frishman WH| title=Cardiac and pericardial tumors. | journal=Cardiol Rev | year= 2012 | volume= 20 | issue= 5 | pages= 237-52 | pmid=22447042 | doi=10.1097/CRD.0b013e31825603e7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22447042 }} </ref>
|}
 
'''Papillary Fibroelastoma'''
:*Surgery is the mainstay of therapy for papillary fibroelastoma.
:*Surgical excision is generally recommended among patients with papillary fibroelastoma (for symptomatic relief).
:*A minimally invasive approach may be possible if the tumor involves the [[aortic valve]]or right atrium.<ref name="Kim-2007">{{cite journal | author=Kim RW, Jeffery ME, Smith MJ, Wilensky RL, Woo EY, Woo YJ. | title=Minimally invasive resection of papillary fibroelastoma in a high-risk patient. | journal=J Cardiovasc Med (Hagerstown) | year=2007 | volume=8 | issue=8 | pages=639-41 | id=PMID 17667039}}</ref> 
:*In the case of aortic valve involvement, excision of the tumor is often valve-sparing, meaning that replacement of the valve with a [[aortic valve replacement|prosthetic valve]] is not necessary. Repair of the native valve with a pericardial patch has been described.<ref name="Westhof-2007">{{cite journal | author=Westhof FB, Chryssagis K, Liangos A, Batz G, Diegeler A. | title=Aortic valve leaflet reconstruction after excision of a papillary fibroelastoma using autologous pericardium. | journal=Thorac Cardiovasc Surg | year=2007 | volume=55 | issue=3 | pages=204-7 | id=PMID 17410513}}</ref>


==References==
==References==
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[[Category:Types of cancer]]
[[Category:Cardiovascular system]]
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[[Category:Surgery]]

Latest revision as of 20:22, 4 July 2022

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dheeraj Makkar, M.D.[2]

Overview

Surgery may be an option in specific cases of malignant tumors.

  • Patients with solitary heart illness and a managed primary tumor are optimal.
  • The tumor must be amenable to resection while maintaining adequate heart function to support life.

Surgery

Whether malignant or benign, clinical signs determine the criteria for emergency surgery.

  • Cardiac tumors can generate a wide range of symptoms, including the four indications for surgery:
    • Restriction of intracardiac blood circulation or interference with valve function
    • Rhythm abnormalities or pericardial effusions with tamponade owing to local penetration
    • Embolization, resulting in systemic or pulmonary impairments
    • Systemic or constitutional symptoms resulting from the tumors
Surgical Treatment of Cardiac Tumors
Tumor Treatment
Myxoma Total excision
    • Surgical intervention is necessary for patients with severe dyspnea or a significant risk of embolism.
    • Surgical mortality rate of less than 5%
    • 2% to 5% of patients are at risk for recurrence[1]

Papillary Fibroelastomas Surgical resection with reconstruction,
  • Less often, valve replacement. [1]
Cardiac Rhabdomyoma Therapeutic resection of the problem portion of the lesion[1]
Cardiac Fibroma Complete excision/ Palliative partial resection[1]
Teratoma Fetal Tumor Excision or Immediate surgery after Cesarian section[1]
Cardiac Lipoma Complete Tumor resection[1]
Hemangioma Conservative in asymptomatic
  • Radical Resection in symptomatic[1]
Hamartomas Surgical Resection[1]

Papillary Fibroelastoma

  • Surgery is the mainstay of therapy for papillary fibroelastoma.
  • Surgical excision is generally recommended among patients with papillary fibroelastoma (for symptomatic relief).
  • A minimally invasive approach may be possible if the tumor involves the aortic valveor right atrium.[2]
  • In the case of aortic valve involvement, excision of the tumor is often valve-sparing, meaning that replacement of the valve with a prosthetic valve is not necessary. Repair of the native valve with a pericardial patch has been described.[3]

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Lamba G, Frishman WH (2012). "Cardiac and pericardial tumors". Cardiol Rev. 20 (5): 237–52. doi:10.1097/CRD.0b013e31825603e7. PMID 22447042.
  2. ↑ Kim RW, Jeffery ME, Smith MJ, Wilensky RL, Woo EY, Woo YJ. (2007). "Minimally invasive resection of papillary fibroelastoma in a high-risk patient". J Cardiovasc Med (Hagerstown). 8 (8): 639–41. PMID 17667039.
  3. ↑ Westhof FB, Chryssagis K, Liangos A, Batz G, Diegeler A. (2007). "Aortic valve leaflet reconstruction after excision of a papillary fibroelastoma using autologous pericardium". Thorac Cardiovasc Surg. 55 (3): 204–7. PMID 17410513.

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