Treatment of Primary Cardiac Tumors in Children: A Single Center 18-Year Experience

Abstract

Abstract This study aimed to compare the clinical characteristics and courses of pediatric patients with cardiac tumors in nonoperative and operative groups to help guide treatment decisions. We reviewed the medical records of patients diagnosed with primary pediatric cardiac tumors at our institution between 2003 and 2020. Demographic data, clinical characteristics, and follow-up data between the operation and nonoperation groups were compared. A total of 56 patients were included in the study. Thirteen patients underwent surgery. The median age was 1.4 months (range, 1 to 18 years). The patients in the operation group had more frequent symptoms or signs, such as desaturation, respiratory difficulty, murmur, a higher mass area /chamber area (MC) ratio, decreased ventricular contractility, and significant obstruction of the flow tract. An MC ratio of 0.568 was the cutoff value for differentiating patients with symptoms or signs of heart failure and decreased ventricular contractility. At the last follow-up, all patients had good ventricular contractility except one patient in the operative group with fibroma. Two patients in the nonoperative group died. Surgery-related mortality or tumor recurrence were not observed. Among pediatric patients with primary cardiac tumors, those with symptoms or signs of heart failure, a high MC ratio, decreased ventricular contractility, and significant flow tract obstruction or embolic risk may be candidates for surgery. In this study, patients had good outcomes with or without surgery, even when the tumor was large, or surgery was performed in early infancy.