Primary cardiac tumors--clinical experiences and late results in 48 patients

Between 1971 and 1987 48 patients (35 female and 13 male) underwent operations at the Department of Cardiovascular Surgery, Justus-Liebig-University Giessen, for primary cardiac tumors. The age of the patients ranged from 21 to 71 years. Clinical symptoms were congestive heart failure, cardiac murmurs and findings similar to mitral stenosis, chest pain, arrhythmias, arterial embolism, myocardial infarction and pericarditis. 39 of the tumors were benign and 9 were malignant. Diagnosis was confirmed by echocardiography and/or cineangiocardiography. The left atrium was most commonly involved, followed by the right atrium. Surgery was performed in all cases using cardiopulmonary bypass. Benign tumors were totally removed, including attachment to the atrial septum or the free wall. In one case the tumor resection was carried out by autotransplantation of the heart. During the perioperative period we lost one of the 39 patients with benign tumors due to low cardiac output. Observing a mean follow up period of 48 months, no recurrence of tumors was noted and all patients are doing well now. The malignant neoplasms could not be removed completely, and in 4 cases only a reduction of the tumor mass was possible. Three of the 9 patients died during the postoperative period. Only one patient survived longer than 48 months. Whereas surgical therapy of malignant cardiac tumors is still a matter of discussion based upon these discouraging results, benign or semimalignant cardiac neoplasms have a very favourable prognosis when the surgical intervention can be performed prior to the occurrence of severe complications, such as congestive heart failure and arterial embolism.(ABSTRACT TRUNCATED AT 250 WORDS)