Surgery for primary cardiac tumors in children early and late results in a multicenter european congenital heart surgeons association study

Massimo A. Padalino, Vladimiro L. Vida, Giovanna Boccuzzo, Marco Tonello, George E. Sarris, Hakan Berggren, Juan V. Comas, Duccio Di Carlo, Roberto M. Di Donato, Tjark Ebels, Viktor Hraska, Jeffrey P. Jacobs, J. William Gaynor, Dominique Metras, Rene Pretre, Marco Pozzi, Jean Rubay, Heikki Sairanen, Christian Schreiber, Bohdan MaruszewskiCristina Basso, Giovanni Stellin

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)22-30
Number of pages9
JournalCirculation
Volume126
Issue number1
DOIs
Publication statusPublished - Jul 3 2012

Keywords

  • Cardiac surgery
  • Cardiac tumors
  • Congenital cardiac defects
  • Outcomes
  • Pediatrics

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Surgery for primary cardiac tumors in children early and late results in a multicenter european congenital heart surgeons association study'. Together they form a unique fingerprint.

  • Cite this

    Padalino, M. A., Vida, V. L., Boccuzzo, G., Tonello, M., Sarris, G. E., Berggren, H., Comas, J. V., Di Carlo, D., Di Donato, R. M., Ebels, T., Hraska, V., Jacobs, J. P., Gaynor, J. W., Metras, D., Pretre, R., Pozzi, M., Rubay, J., Sairanen, H., Schreiber, C., ... Stellin, G. (2012). Surgery for primary cardiac tumors in children early and late results in a multicenter european congenital heart surgeons association study. Circulation, 126(1), 22-30. https://doi.org/10.1161/CIRCULATIONAHA.111.037226