Results of treatment of 17 patients with heart tumour

BackgroundBetween 1989 and 1997, 17 patients underwent surgery for excision of primary cardiac tumour at the Department for Cardiovascular Surgery in Ljubljana.Patients and methodsThere were 13 female (76.5%) and four male (23.5%) patients with an average age of 49±14 years (mean±SD). The study was retrospective. Special attention was paid to clinical presentation, method of diagnosis, elapsed time between the confirmed diagnosis and excision of the tumour, operatively determined location of tumour and post-operative course—diuresis in first 48 h, levels of CK and CK-MB, on first and on second day after operation and time of hospitalization.ResultsThirteen patients (76.5%) had cardiac symptoms at the time of presentation (dyspnoea, syncope, vertigo, palpitations) and four (23.5%) had embolic complications. In all the patients diagnosis was made by echocardiography. Average elapsed time between the confirmed diagnosis and the operation was 26±40 (mean±SD) days. Histological examination revealed myxoma in 15 patients (88.2%), one patient had lipoma and one malignant haemangiosarcoma. The most common location of tumour was in the left atrium (12 patients; 70.6%). Post-operative complications occurred in four patients (23.5%); 76.5% of patients had diuresis in the range between 0.8 and 2.0 ml/h/kg; there was no post-operative oligouric renal failure. Average levels of both CK and CK-MB were statistically significantly lower on the second day after operation, there was no case of peri-operative myocardial infarction and post-operative death did not occur. One patient with multiple myxoma had two recurrences.ConclusionsSymptoms in patients with heart tumours, especially at the beginning of illness, are often uncharacteristic. Due to the non-specific presentation of cardiac tumours, a high index of suspicion is needed. The diagnostic method of choice is echocardiography. Operative removal of tumour is a safe procedure and recurrences in patients with benign tumours are rare.