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Primer Kardiyak Tümörler ve Cerrahinin Uzun Dönem Sonuçları: 81 Hastaya Ait 38 Yıllık Tecrübe

Year 2019, Volume: 72 Issue: 1, 97 - 101, 13.06.2019

Ulaş Kumbasar

Abstract

Amaç: Bu tek merkezli çalışmada, kurumumuzun primer kardiyak tümörler nedeniyle opere edilmiş 81 hastadaki 38 yıllık tecrübesini gözden geçirdik.

Gereç ve Yöntem: Bu çalışmaya dahil edilen 81 hastanın %95’inde (n=77) benign %5’inde (n=4) ise malign tümörler bulunmaktaydı. Benign tümörler,
miksomaları (n=66, %81,5), rabdomyomaları (n=9, %11,1) ve papiller fibroelastomaları (n=2, %2,5) içeriyordu. Malign tümörler ise anjiosarkomaları
(n=2, %2,5) ve rabdomyosarkomaları (n=2, %2,5) kapsamaktaydı. Başvuru sırasında en sık görülen semptomlar disepne (%49,4), çarpıntı (%30,9) ve
sistemik embolizasyondu (%14,8). Tümörler, 61 olguda (%75,3) sol atriumdan, 12 olguda (%14,8) sağ atriumdan 5 olguda (%6,2) sağ ventrikülden
ve 3 olguda (%3,7) sol ventrikülden köken alıyordu. Cerrahi yaklaşım, 47 olguda (%58) uniatriyaldi. Bilateral atriyotomi 26 hastada (%32) uygulandı.
Postoperatif komplikasyon insidansı %14,8 (n=12) olarak tespit edildi.

Bulgular: Hastane içi ölüm (30 günlük), %4,9’du (n=4). Miksomalarla karşılaştırıldığında, diğer benign ve malign tümörlerin sürvilerinin
karakteristiklerinin daha kötü olduğu görüldü.

Sonuç: Primer kardiyak tümörlerin, negatif sınırlar ile cerrahi rezeksiyonu, çok iyi uzun dönem sağkalım sağlamaktadır; kardiyak miksomalı hastaların
sağkalım karakteristikleri genel popülasyon ile benzerlik göstermektedir.

Keywords

İntrakardiyak Tümörler Cerrahi Rezeksiyon Sağkalım

Ethical Statement

-

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. Silverman NA. Primary cardiac tumors. Ann Surg. 1980;191:127-138.
  • 2. Elbardissi AW, Dearani JA, Daly RC, et al. Survival after resection of primary cardiac tumors: a 48-year experience. Circulation. 2008;118:S7-15.
  • 3. Simpson L, Kumar SK, Okuno SH, et al. Malignant primary cardiac tumors: review of a single institution experience. Cancer. 2008;112:2440-2446.
  • 4. Habertheuer A, Laufer G, Wiedemann D, et al. Primary cardiac tumors on the verge of oblivion: a European experience over 15 years. J Cardiothorac Surg. 2015;10:56.
  • 5. Keeling IM, Oberwalder P, Anelli-Monti M, et al. Cardiac myxomas: 24 years of experience in 49 patients Eur J Cardiothorac Surg. 2002;22:971-977.
  • 6. Cetin G, Gursoy M, Ugurlucan M, et al. Single-institutional 22 years experience on cardiac myxomas. Angiology. 2010;61:504-509.
  • 7. Garatti A, Nano G, Canziani A, et al. Surgical excision of cardiac myxomas: twenty years experience at a single institution. Ann Thorac Surg. 2012;93:825-831.
  • 8. Grebenc ML, Rosado-de-Christenson ML, Green CE, et al. Cardiac myxoma: imaging features in 83 patients. Radiographics. 2002;22:673-162.
  • 9. Elbardissi AW, Dearani JA, Daly RC, et al. Embolic potential of cardiac tumors and outcome after resection: a case-control study. Stroke. 2009;40:156-62.
  • 10. Bruce CJ. Cardiac tumours: diagnosis and management. Heart. 2011;97:151- 160.
  • 11. Paraskevaidis IA, Michalakeas CA, Papadopoulos CH, et al. Cardiac tumors. ISRN Oncol. 2011;2011:208929.
  • 12. Araoz PA, Mulvagh SL, Tazelaar HD, et al. CT and MR imaging of benign primary cardiac neoplasms with echocardiographic correlation. Radiographics. 2000;20:1303-1319.
  • 13. Lobo A, Lewis JF, Conti CR. Intracardiac masses detected by echocardiography: case presentations and review of the literature. Clin Cardiol. 2000;23:702- 708.
  • 14. Hirota M, Ishikawa N, Oi M, et al. Large primary cardiac sarcoma on the left ventricular free wall: is total excision contraindicated? Interact Cardiovasc Thorac Surg. 2010;11:670-672.
  • 15. Jha NK, Khouri M, Murphy DM, et al. Papillary fibroelastoma of the aortic valve--a case report and literature review. J Cardiothorac Surg. 2010;5:84.
  • 16. Stevens LM, Lapierre H, Pellerin M, et al. Atrial versus biatrial approaches for cardiac myxomas. Interact Cardiovasc Thorac Surg. 2003;2:521-525.
  • 17. Mishra A, Shah M, Sharma P, et al. Operative management of intracardiac myxomas: A single center experience. Med J Armed Forces India. 2014;70:5- 9.
  • 18. Chitwood WR, Jr. Cardiac neoplasms: current diagnosis, pathology, and therapy. J Card Surg. 1988;3:119-154.
  • 19. Disesa VJ, Collins JJ, Jr, Cohn LH. Considerations in the surgical management of left atrial myxoma. J Card Surg. 1988;3:15-22.
  • 20. Hua A, Shemin RJ, Gordon JP, et al. Minimally invasive robotically assisted surgical resection of left atrial endocardial papillary fibroelastomas. J Thorac Cardiovasc Surg. 2014;148:3247-3249.
  • 21. Owais TA, Färber G, Garbade J, Excision of a left atrial myxoma via a minimally-invasive technique: a possible routine access. nteract Cardiovasc Thorac Surg. 2011;12:875-877.
  • 22. Ipek G, Erentug V, Bozbuga N, et al. Surgical management of cardiac myxoma. J Card Surg. 2005;20:300-304.
  • 23. Gerbode F, Kerth WJ, Hill JD. Surgical management of tumors of the heart. Surgery. 1967;61:94-101.
  • 24. St John Sutton MG, Mercier LA, Giuliani ER, et al. Atrial myxomas: a review of clinical experience in 40 patients. Mayo Clin Proc. 1980;55:371-376.
  • 25. Blondeau P. Primary cardiac tumors--French studies of 533 cases. Thorac Cardiovasc Surg. 1990;38 Suppl 2:192-195.
  • 26. McCarthy PM, Piehler JM, Schaff HV, et al. The significance of multiple, recurrent, and “complex” cardiac myxomas. J Thorac Cardiovasc Surg. 1986;91:389-396.

Primary Cardiac Tumors and Long-Term Results of Surgery: A 38-Year Experience in 81 Patients

Year 2019, Volume: 72 Issue: 1, 97 - 101, 13.06.2019

Ulaş Kumbasar

Abstract

Objectives: In this study, we examined our 38 years of institutional experience with 81 patients operated for primary cardiac tumor.

Materials and Methods: Among the 81 patients included, 95% (n=77) had benign tumors and 5% (n=4) had malignant tumors. Benign tumors were myxomas (n=66, 81.5%), rhabdomyomas (n=9, 11.1%) and papillary fibroelastomas (n=2, 2.5). Malignant tumors included angiosarcomas (n=2, 2.5%) and rhabdomyosarcomas (n=2, 2.5%). Common symptoms of admission were dyspnea (49.4%), palpitation (30.9%) and systemic embolization (14.8%). Tumors originated from the left atrium in 61 cases (75.3%), right atrium in 12 cases (14.8%), right ventricle in 5 cases (6.2%) and left ventricle in 3 cases (3.7%). The surgical method was uniatrial in 47 patients (58%). Bilateral atriotomy was performed in 26 patients (32%). The incidence of postoperative complication was 14.8% (n=12).

Results: In-hospital (30 day) mortality was 4.9% (n=4). The survival of other benign tumors and malignant tumors were poorer than the patients with myxomas.

Conclusion: Surgical resection of primary cardiac tumors with negative margins have excellent long-term survival which are similar to general population.

Keywords

Intracardiac Tumors Surgical resection Survival

Ethical Statement

-

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. Silverman NA. Primary cardiac tumors. Ann Surg. 1980;191:127-138.
  • 2. Elbardissi AW, Dearani JA, Daly RC, et al. Survival after resection of primary cardiac tumors: a 48-year experience. Circulation. 2008;118:S7-15.
  • 3. Simpson L, Kumar SK, Okuno SH, et al. Malignant primary cardiac tumors: review of a single institution experience. Cancer. 2008;112:2440-2446.
  • 4. Habertheuer A, Laufer G, Wiedemann D, et al. Primary cardiac tumors on the verge of oblivion: a European experience over 15 years. J Cardiothorac Surg. 2015;10:56.
  • 5. Keeling IM, Oberwalder P, Anelli-Monti M, et al. Cardiac myxomas: 24 years of experience in 49 patients Eur J Cardiothorac Surg. 2002;22:971-977.
  • 6. Cetin G, Gursoy M, Ugurlucan M, et al. Single-institutional 22 years experience on cardiac myxomas. Angiology. 2010;61:504-509.
  • 7. Garatti A, Nano G, Canziani A, et al. Surgical excision of cardiac myxomas: twenty years experience at a single institution. Ann Thorac Surg. 2012;93:825-831.
  • 8. Grebenc ML, Rosado-de-Christenson ML, Green CE, et al. Cardiac myxoma: imaging features in 83 patients. Radiographics. 2002;22:673-162.
  • 9. Elbardissi AW, Dearani JA, Daly RC, et al. Embolic potential of cardiac tumors and outcome after resection: a case-control study. Stroke. 2009;40:156-62.
  • 10. Bruce CJ. Cardiac tumours: diagnosis and management. Heart. 2011;97:151- 160.
  • 11. Paraskevaidis IA, Michalakeas CA, Papadopoulos CH, et al. Cardiac tumors. ISRN Oncol. 2011;2011:208929.
  • 12. Araoz PA, Mulvagh SL, Tazelaar HD, et al. CT and MR imaging of benign primary cardiac neoplasms with echocardiographic correlation. Radiographics. 2000;20:1303-1319.
  • 13. Lobo A, Lewis JF, Conti CR. Intracardiac masses detected by echocardiography: case presentations and review of the literature. Clin Cardiol. 2000;23:702- 708.
  • 14. Hirota M, Ishikawa N, Oi M, et al. Large primary cardiac sarcoma on the left ventricular free wall: is total excision contraindicated? Interact Cardiovasc Thorac Surg. 2010;11:670-672.
  • 15. Jha NK, Khouri M, Murphy DM, et al. Papillary fibroelastoma of the aortic valve--a case report and literature review. J Cardiothorac Surg. 2010;5:84.
  • 16. Stevens LM, Lapierre H, Pellerin M, et al. Atrial versus biatrial approaches for cardiac myxomas. Interact Cardiovasc Thorac Surg. 2003;2:521-525.
  • 17. Mishra A, Shah M, Sharma P, et al. Operative management of intracardiac myxomas: A single center experience. Med J Armed Forces India. 2014;70:5- 9.
  • 18. Chitwood WR, Jr. Cardiac neoplasms: current diagnosis, pathology, and therapy. J Card Surg. 1988;3:119-154.
  • 19. Disesa VJ, Collins JJ, Jr, Cohn LH. Considerations in the surgical management of left atrial myxoma. J Card Surg. 1988;3:15-22.
  • 20. Hua A, Shemin RJ, Gordon JP, et al. Minimally invasive robotically assisted surgical resection of left atrial endocardial papillary fibroelastomas. J Thorac Cardiovasc Surg. 2014;148:3247-3249.
  • 21. Owais TA, Färber G, Garbade J, Excision of a left atrial myxoma via a minimally-invasive technique: a possible routine access. nteract Cardiovasc Thorac Surg. 2011;12:875-877.
  • 22. Ipek G, Erentug V, Bozbuga N, et al. Surgical management of cardiac myxoma. J Card Surg. 2005;20:300-304.
  • 23. Gerbode F, Kerth WJ, Hill JD. Surgical management of tumors of the heart. Surgery. 1967;61:94-101.
  • 24. St John Sutton MG, Mercier LA, Giuliani ER, et al. Atrial myxomas: a review of clinical experience in 40 patients. Mayo Clin Proc. 1980;55:371-376.
  • 25. Blondeau P. Primary cardiac tumors--French studies of 533 cases. Thorac Cardiovasc Surg. 1990;38 Suppl 2:192-195.
  • 26. McCarthy PM, Piehler JM, Schaff HV, et al. The significance of multiple, recurrent, and “complex” cardiac myxomas. J Thorac Cardiovasc Surg. 1986;91:389-396.
There are 26 citations in total.

Details

Primary Language English
Subjects Surgical Diseases Nursing​​
Journal Section Articles
Authors

Ulaş Kumbasar 0000-0003-0616-1326

Project Number -
Publication Date June 13, 2019
Published in Issue Year 2019 Volume: 72 Issue: 1

Cite

APA Kumbasar, U. (2019). Primary Cardiac Tumors and Long-Term Results of Surgery: A 38-Year Experience in 81 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 72(1), 97-101. https://doi.org/10.4274/atfm.galenos.2019.30602
AMA Kumbasar U. Primary Cardiac Tumors and Long-Term Results of Surgery: A 38-Year Experience in 81 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. June 2019;72(1):97-101. doi:10.4274/atfm.galenos.2019.30602
Chicago Kumbasar, Ulaş. “Primary Cardiac Tumors and Long-Term Results of Surgery: A 38-Year Experience in 81 Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 72, no. 1 (June 2019): 97-101. https://doi.org/10.4274/atfm.galenos.2019.30602.
EndNote Kumbasar U (June 1, 2019) Primary Cardiac Tumors and Long-Term Results of Surgery: A 38-Year Experience in 81 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası 72 1 97–101.
IEEE U. Kumbasar, “Primary Cardiac Tumors and Long-Term Results of Surgery: A 38-Year Experience in 81 Patients”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 72, no. 1, pp. 97–101, 2019, doi: 10.4274/atfm.galenos.2019.30602.
ISNAD Kumbasar, Ulaş. “Primary Cardiac Tumors and Long-Term Results of Surgery: A 38-Year Experience in 81 Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 72/1 (June 2019), 97-101. https://doi.org/10.4274/atfm.galenos.2019.30602.
JAMA Kumbasar U. Primary Cardiac Tumors and Long-Term Results of Surgery: A 38-Year Experience in 81 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2019;72:97–101.
MLA Kumbasar, Ulaş. “Primary Cardiac Tumors and Long-Term Results of Surgery: A 38-Year Experience in 81 Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 72, no. 1, 2019, pp. 97-101, doi:10.4274/atfm.galenos.2019.30602.
Vancouver Kumbasar U. Primary Cardiac Tumors and Long-Term Results of Surgery: A 38-Year Experience in 81 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2019;72(1):97-101.
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