1. Surgery for Primary Cardiac Tumors in Children Early and Late Results in a Multicenter European Congenital Heart Surgeons Association Study
- Author
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Massimo A. Padalino, George E. Sarris, Jean Rubay, Vladimiro L. Vida, Christian Schreiber, Viktor Hraska, René Prêtre, Håkan Berggren, Giovanna Boccuzzo, Tjark Ebels, Giovanni Stellin, J. William Gaynor, Bohdan Maruszewski, Marco Pozzi, Marco Tonello, Juan V. Comas, Cristina Basso, Roberto M. Di Donato, Heikki Sairanen, Duccio Di Carlo, Dominique Metras, Jeffrey P. Jacobs, Faculteit Medische Wetenschappen/UMCG, Cardiovascular Centre (CVC), University of Zurich, Padalino, Massimo A, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique, and UCL - (SLuc) Centre des cardiopathies congénitales de l'adulte
- Subjects
Male ,RHABDOMYOMAS ,CHILDHOOD ,030204 cardiovascular system & hematology ,Rhabdomyoma ,outcomes ,Cohort Studies ,Heart Neoplasms ,Postoperative Complications ,2737 Physiology (medical) ,0302 clinical medicine ,Prenatal Diagnosis ,TUBEROUS SCLEROSIS ,Child ,Mortality rate ,3. Good health ,Cardiac surgery ,Europe ,Survival Rate ,Treatment Outcome ,OF-THE-LITERATURE ,Child, Preschool ,Female ,Cardiology and Cardiovascular Medicine ,cardiac surgery ,Heart Defects, Congenital ,medicine.medical_specialty ,Adolescent ,pediatrics ,610 Medicine & health ,Malignancy ,2705 Cardiology and Cardiovascular Medicine ,Hemangioma ,03 medical and health sciences ,Physicians ,Physiology (medical) ,Preoperative Care ,medicine ,Humans ,congenital cardiac defects ,Adverse effect ,Retrospective Studies ,cardiac tumors ,ATRIAL-MYXOMA ,CARNEY COMPLEX ,PERICARDIAL TUMORS ,business.industry ,Infant, Newborn ,RIGHT-VENTRICULAR FIBROMA ,Infant ,Myxoma ,NATURAL-HISTORY ,medicine.disease ,10020 Clinic for Cardiac Surgery ,Surgery ,030228 respiratory system ,EXPERIENCE ,Fibroma ,business ,Follow-Up Studies - Abstract
Background— To evaluate indications and results of surgery for primary cardiac tumors in children. Methods and Results— Eighty-nine patients aged ≤18 years undergoing surgery for cardiac tumor between 1990 and 2005 from 16 centers were included retrospectively (M/F=41/48; median age 4.3 months, range 1 day to 18 years). Sixty-three patients (68.5%) presented with symptoms. Surgery consisted of complete resection in 62 (69.7%) patients, partial resection in 21 (23.6%), and cardiac transplant in 4 (4.5%). Most frequent histotypes (93.2%) were benign (rhabdomyoma, myxoma, teratoma, fibroma, and hemangioma). Postoperative complications occurred in 29.9%. Early and late mortality were 4.5% each (mean follow-up, 6.3±4.4 years); major adverse events occurred in 28.2% of the patients; 90.7% of patients are in New York Heart Association class I. There were no statistically significant differences in survival, postoperative complications, or adverse events after complete and partial resection in benign tumors other than myxomas. Cardiac transplant was associated significantly with higher mortality rate ( P= 0.006). Overall mortality was associated to malignancy ( P =0.0008), and adverse events during follow-up ( P =0.005). Conclusions— Surgery for primary cardiac tumors in children has good early and long-term outcomes, with low recurrence rate. Rhabdomyomas are the most frequent surgical histotypes. Malignant tumors negatively affect early and late survival. Heart transplant is indicated when conservative surgery is not feasible. Lack of recurrence after partial resection of benign cardiac tumors indicates that a less risky tumor debulking is effective for a subset of histotypes such as rhabdomyomas and fibromas.
- Published
- 2012
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