Surgical Treatment of Primary Cardiac Tumors—Experience with 45 Patients

Abstract

Primary cardiac tumors are very rare and the majority of them are histologically benign and surgically curable. During a 30-year period from 1963 to January 1993, 45 cases of primary cardiac tumors were surgically excised at the National Taiwan University Hospital, representing 0.52% of 8,695 open heart surgical cases during the same period. In this series, 42 cases (94%) were benign tumors; 39 (88%) were myxoma (30 female, 9 male), and 32 (82%) originated in the left atrium. None were discovered in the left ventricle. In all but the first 6 cases, tumors in patients with myxoma in the left atrium were successfully excised by the transseptal approach. There were 3 patients with rare benign tumors: intracardiac goiter, rhabdomyoma, and hemangioma respectively. The intracardiac goiter was completely excised with no ectopic thyroid tissue after operation and the other 2 received palliative resection. The latter 2 patients suffered no recurrence. Rhabdomyosarcoma, leiomyosarcoma and malignant lymphoma were noted in one patient each, all of whom died of low cardiac output in the early postoperative course. In our experience, the majority of primary cardiac tumors were benign and located in the left atrium. The long-term result of surgical treatment of benign cardiac tumors is excellent, even incases of incomplete resection, while the results from surgical treatment of malignant tumors is poor.