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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
[Clinical features and surgical treatment effect of patients with cardiac cavernous hemangioma]
1Departments of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Insights
Cardiac cavernous hemangioma presents with varied symptoms and is difficult to detect pre-operatively. Individualized surgical treatment offers good outcomes, but further large-scale studies are needed.
Area of Science:
- Cardiovascular Surgery
- Pathology
- Diagnostic Imaging
Background:
- Cardiac cavernous hemangioma is a rare vascular tumor.
- Clinical presentation is often non-specific.
- Preoperative diagnosis, especially for cardiac valve hemangioma, can be challenging.
Purpose of the Study:
- To investigate the clinical characteristics of cardiac cavernous hemangioma.
- To evaluate the effectiveness of surgical treatment for this condition.
Main Methods:
- Retrospective analysis of clinical data from 9 patients with cardiac cavernous hemangioma.
- Surgical treatment and postoperative histological examination were performed.
- Follow-up evaluation for recurrence or enlargement.
Main Results:
- Patients presented with diverse symptoms, including asymptomatic cases, palpitations, dyspnea, epigastric discomfort, and fever.
- Electrocardiogram and echocardiography showed varied findings; echocardiography had limitations in detecting cardiac masses.
- Surgical resection was performed, with en bloc resection in most cases and partial resection when adjacent structures were involved. One case involved mitral valve cavernous angioma excision.
- No recurrence or enlargement was observed during follow-up.
Conclusions:
- Cardiac cavernous hemangioma lacks specific clinical features, making diagnosis difficult.
- Echocardiography may not reliably detect cardiac valve hemangioma.
- Individualized surgical approaches yield favorable outcomes.
- Larger studies are required to further elucidate clinical features and treatment efficacy.
Abstract:
Objective: To investigate the clinical features and surgical treatment effect of patients with cardiac cavernous hemangioma. Methods: Clinical data of 9 patients (5 male, aged from 4 to 53 years old) with cardiac cavernous hemangioma, who underwent surgical treatment from November 2002 to March 2015 and the diagnosis of cardiac cavernous hemangioma was confirmed by postoperative histological examination, were retrospectively analyzed. Effects of surgical treatment were analyzed. Results: Four patients were asymptomatic (heart murmur presented in 3 patients during physical examination). Three patients presented with palpitation, chest distress, and short of breath. One patient presented with epigastric discomfort and another patient presented with intermittent fever for more than 10 months. ST and T wave changes of electrocardiogram were found in 2 patients, cardiac mass was detected in the right heart chamber in 5 patients by echocardiography, and no cardiac mass was detected the rest 4 patients. Cardiac masses were resected en bloc, then the adjacent tissues were repaired in 7 patients, and mass was partially resected due to the involvement with adjacent heart structure. No cardiac mass was found during operation in 1 case, impaired mitral valve structure was excised and postoperative pathologically confirmed as cardiac valve cavernous angioma on the excised mitral valve structure. No signs of recurrence or enlargement of cardiac cavernous hemangioma were found during the 11(10, 11)years follow up. Conclusions: There is no specific clinical feature for patients with cardiac cavernous hemangioma. It is difficult to detect the cardiac valve cavernous angioma by echocardiography before surgery. Individualized surgical treatment is associated with good clinical outcome in this patient cohort. However, the clinical features and surgical treatment effect of patients with cardiac cavernous hemangioma still need to investigate in large sample trial.
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