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[Heart tumors in newborn infants and infants. Apropos of 5 cases]
P M Roux1, G Ghorayeb, G Touati
1Service de Chirurgie Cardio-Vasculaire et Thoracique, Hôpital Laennec, Paris.
Insights
This study reviewed 5 pediatric cardiac neoplasm resections, including fetal diagnoses. Surgical outcomes varied, with 4 survivors achieving good functional status post-operation.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Oncology
Context:
- Primary cardiac neoplasms are rare in children.
- Early detection through prenatal echocardiography is crucial.
- Diagnosis can be challenging, often presenting with murmurs or heart failure.
Purpose:
- To report surgical outcomes for primary cardiac neoplasms in infants and children.
- To highlight the role of echocardiography in prenatal and postnatal diagnosis.
- To analyze the feasibility and results of surgical resection.
Summary:
- Five children underwent resection of primary cardiac tumors between February 1985 and March 1987.
- Tumor types included hemangioma, pseudomyxoma, and rhabdomyoma.
- Surgical approaches varied, with some resections requiring cardiopulmonary bypass (CPBP) and others not.
- Outcomes included one death from heart failure, with four survivors in functional class I at follow-up.
Impact:
- Demonstrates the possibility of surgical intervention for pediatric cardiac tumors.
- Emphasizes the importance of multidisciplinary care for these complex cases.
- Highlights the potential for long-term survival and good functional recovery in survivors.
Abstract:
Between February 1985 and March 1987, 5 children underwent resection of primary cardiac neoplasms, 3 of them in the first days of life and 2 before the age of 6 months. Routine echocardiographic follow-up of pregnancies allowed detection of cardiac tumors in 2 foetuses 30 and 36 weeks old. In 3 children the diagnosis was suspected by the discovery of cardiac murmur or congestive heart failure. The first case was an hemangioma, originating from outside of the left ventricular wall, which could be resected without cardiopulmonary bypass (CPBP). The other case was a pseudomyxoma, spreading extensively inside the right atrium. The third case was a rhabdomyoma arising from the pulmonary infundibulum with clinical manifestations of tuberous sclerosis. The last two patients had intraseptal lesions, just above the aortic valve; complete resection was therefore impossible, particularly in one patient with multiple tumors. There was one death related to congestive heart failure. The remaining four survivors were followed up for an average of 18.4 months (+/- 12.9) and all were in functional class I. Echocardiographic follow-up showed evidence of a residual subaortic lesion in one asymptomatic patient.