Single Center Clinical Study Of Primary Cardiac Tumors

ObjectiveTo discuss the clinical characteristics of primary cardiac tumors for enhancing its diagnosis and treatment.It could provide treatment strategies to the interventional therapy in postoperative arrhythmia patients.MethodsBetween Jan2000and Dec2011,clinical characteristics of186patients with primary cardiac tumors undergoing surgical treatment were investigated and analyzed.The diagnosis was identified by echocardiography before operration and by pathological test after operration. Based on the pathological examination,the patients were divided into three groups:myxomas group (n=171),benign nonmyxomas group (n=7),and malignant tumor group (n=8),and the datas were reviewed and analyzed.Results1.The incidence of benign neoplasms(95.7%)was higher than that of malignant masses(4.3%).All the patients were determined by the pathological examination; and the majority of primary cardiac tumors were myxomas(91.9%).The incidence of female patients with myxomas was not higher than that of male(P>0.05).The prevalence rates of primary cardiac tumors were the highest in patients aged41-50years among different age groups.2.Left atrial myxomas (151cases) are most commonly seen in patients with primary cardiac tumors.Right atrial myxomas (15cases) were taked second place.The malignant often grew in the right heart.3.Palpitation and dyspnea on excitement are the most frequent symptoms of primary cardiac tumours,it was the chief complaint of154(83.9%) patients.4.The hospital mortality rate was1.2%(2/171) in myxomas group.All the7patients with benign nonmyxomas had no postoperative death. Two patients of in malignant tumor group were died after operation.The hospital mortality of myxomas group was less than that malignant tumor group CP<0.05).The mortality of right heart tumors was higher than the left(P<0.05).5.The recurrent rate of myxomas group was3.5%(6/171).The long-term death rate was1.8%(3/171).All the7patients with benign nonmyxomas had no long-term death observed.The other5patients in malignant tumor group died of tumor recurrence after surgery,except only one still alive.4patients died of tumor recurrence in1year after surgery,1patients died of tumor recurrence at22months after surgery,and the remaining heart space-occupying lesions recovered well. 6.11patients had atrial tachyarrhythmia after operation, and one of them had atrial fibrillation which was succeeded to restore sinus rhythm through radiofrequency ablation.Conclusions1.Benign cardiac tumors are much more prevalent than malignancies in patients undergoing cardiac surgical treatment.Most of primary heart tumor are left atrium myxomas in clinical cases.2.The clinical features of primary cardiac tumours are complex.Palpitation and dyspneaon exertion were the most frequent symptoms.3.Right cardiac tumor is rare. The proportion of malignant tumor is higher in right heart than in left heart.4.Surgical resection is the first choice in the treatment of prmiary cardiac tumors.The results and prognosis of the patients are closely related to pathology and the invasion extension of tumors.5.Surgical scar was probably the main cause that increased the difficulty in the radiofrequency ablation of postoperative arrhythmia in cardiac tumor patients.