Cryoablation as an adjunct to the excision of primary cardiac tumors

Resection of atrial myxomas and valvular papillary fibroelastomas has traditionally involved sharp excision of the tumor accompanied by a small margin of normal tissue when feasible. Cryoablation of the tumor base is a potentially effective adjunct to radical excision alone and may prevent collateral damage and/or the need for reconstruction and late recurrence. This study aimed to evaluate the safety and effectiveness of adjunctive cryoablation with cardiac tumor resection.

We performed a retrospective analysis of all patients from our institution who underwent resection of first occurrence of a myxoma or papillary fibroelastoma between January 1, 1999, and December 31, 2024. Operative reports were reviewed to determine whether cryoablation was used as an adjunct to resection. Echocardiographic images were reviewed to determine tumor recurrence.

Of the 94 patients included in this study, 50 underwent resection with adjunctive cryoablation around the tumor base and 44 underwent sharp excision alone. Fifty-one patients had a myxoma (54%) and 43 patients had a fibroelastoma (46%). Tumor recurrence was detected in 3 (3%) patients overall. All recurrences were in the sharp excision group (3/44, 7%), compared with none in the cryoablation group (P = .098).

Cryoablation was an effective adjunct that reduced recurrence without increasing complications after benign cardiac tumor resection.