INTRODUCTION: Primary cardiac tumors are a rare condition presenting with a variety of symptoms. The outcomes of their surgical treatment in the modern era from central Europe have not been recently reported. AIM: To evaluate the short- and long-term outcomes of the cardiac tumor operations at our department throughout the last 20 years. MATERIAL AND METHODS: This was a retrospective analysis of all primary cardiac tumor operations performed at our institution between 2000 and 2020. Perioperative data were extracted from patient records. Long-term data were provided by the National Registry of Cardiac Surgery. RESULTS: Sixty procedures for primary cardiac tumor were performed throughout the study period. The most common type of tumor was myxoma (88%), followed by fibroelastoma (8%), lipoma (2%) and sarcoma (2%). There were 2 perioperative deaths (3%). The most common perioperative complication was atrial fibrillation (47%). One (2%) patient underwent reoperation 6 years later because of myxoma recurrence. We recorded 13 long-term deaths, but only 1 patient died as a consequence of cardiac tumor (sarcoma) 15 months after the surgery. Long-term survival of the cohort was comparable with the age- and sex-matched general population up to 15 years postoperatively (relative survival 0.91, CI 0.68-1.23). Rich histopathological illustrations are provided in the online supplementary material. CONCLUSIONS: Surgical resection is the standard treatment of primary cardiac tumors. The outcomes of benign tumors are excellent and the long-term postoperative survival is comparable with the general population. The prognosis of malignant tumors remains poor.

Department of Cardiac Surgery Charles University Faculty of Medicine and University Hospital Hradec Kralove Czech Republic

Department of Cardiology Pardubice Hospital Czech Republic

The Fingerland Department of Pathology Charles University Faculty of Medicine and University Hospital Hradec Kralove Czech Republic

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Centofanti P, Di Rosa E, Deorsola L, Dato GM, Patanè F, La Torre M, Barbato L, Verzini A, Fortunato G, di Summa M. Primary cardiac tumors: early and late results of surgical treatment in 91 patients. Ann Thorac Surg. 1999;68:1236–41. PubMed

Sarjeant JM, Butany J, Cusimano RJ. Cancer of the heart: epidemiology and management of primary tumors and metastases. Am J Cardiovasc Drugs. 2003;3:407–21. PubMed

Yanagawa B, Mazine A, Chan EY, Barker CM, Gritti M, Reul RM, Ravi V, Ibarra S, Shapira OM, Cusimano RJ, Reardon MJ. Surgery for tumors of the heart. Semin Thorac Cardiovasc Surg. 2018;30:385–97. PubMed

Elbardissi AW, Dearani JA, Daly RC, Mullany CJ, Orszulak TA, Puga FJ, Schaff HV. Survival after resection of primary cardiac tumors: a 48-year experience. Circulation. 2008;118:S7–15. PubMed

Molina JE, Edwards JE, Ward HB. Primary cardiac tumors: experience at the University of Minnesota. Thorac Cardiovasc Surg. 1990;38(Suppl 2):183–91. PubMed

Simpson L, Kumar SK, Okuno SH, Schaff HV, Porrata LF, Buckner JC, Moynihan TJ. Malignant primary cardiac tumors: review of a single institution experience. Cancer. 2008;112:2440–6. PubMed

Pinede L, Duhaut P, Loire R. Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases. Medicine. 2001;80:159–72. PubMed

Mkalaluh S, Szczechowicz M, Torabi S, Schmack B, Sabashnikov A, Dib B, Karck M, Weymann A. Surgical treatment of cardiac tumors: insights from an 18-year single-center analysis. Med Sci Monit. 2017;23:6201–9. PubMed PMC

Endo A, Ohtahara A, Kinugawa T, Mori M, Fujimoto Y, Yoshida A, Kuroda H, Mori T, Mashiba H, Shigemasa C. Characteristics of 161 patients with cardiac tumors diagnosed during 1993 and 1994 in Japan. Am J Cardiol. 1997;79:1708–11. PubMed

Gowda RM, Khan IA, Nair CK, Mehta NJ, Vasavada BC, Sacchi TJ. Cardiac papillary fibroelastoma: a comprehensive analysis of 725 cases. Am Heart J. 2003;146:404–10. PubMed

Keeling IM, Oberwalder P, Anelli-Monti M, Schuchlenz H, Demel U, Tilz GP, Rehak P, Rigler B. Cardiac myxomas: 24 years of experience in 49 patients. Eur J Cardiothorac Surg. 2002;22:971–7. PubMed

Kenawy A, Abdelbar A, Zacharias J. Minimally invasive resection of benign cardiac tumors. J Thorac Dis. 2021;13:1993–9. PubMed PMC

Perek B, Misterski M, Stefaniak S, Ligowski M, Puślecki M, Jemielity M. Early and long-term outcome of surgery for cardiac myxoma: experience of a single cardiac surgical centre. Kardiol Pol. 2011;69:558–64. PubMed

Steiner I. Kardiopatologie pro patology i kardiology. Prague: Galen; 2010.

Miller DV, Revelo MP. Diagnostic Pathology: Cardiovascular. 2nd edn. AMIRSYS; 2018.

Matějková A, Fabián O. Differential diagnosis of heart tumours. Cesk Patol. 2020;56:18–25. PubMed

Neuville A, Collin F, Bruneval P, Parrens M, Thivolet F, Gomez-Brouchet A, Terrier P, de Montpreville VT, Le Gall F, Hostein I, Lagarde P, Chibon F, Coindre JM. Intimal sarcoma is the most frequent primary cardiac sarcoma: clinicopathologic and molecular retrospective analysis of 100 primary cardiac sarcomas. Am J Surg Pathol. 2014;38:461–9. PubMed

Vassiliadis N, Vassiliadis K, Karkavelas G. Sudden death due to cardiac myxoma. Med Sci Law. 1997;37:76–8. PubMed

Chakfé N, Kretz JG, Valentin P, Geny B, Petit H, Popescu S, Edah-Tally S, Massard G. Clinical presentation and treatment options for mitral valve myxoma. Ann Thorac Surg. 1997;64:872–7. PubMed

Ha JW, Kang WC, Chung N, Chang BC, Rim SJ, Kwon JW, Jang Y, Shim WH, Cho SY, Kim SS, Cho SH. Echocardiographic and morphologic characteristics of left atrial myxoma and their relation to systemic embolism. Am J Cardiol. 1999;83:1579–1582. a1578. PubMed

Topol EJ, Biern RO, Reitz BA. Cardiac papillary fibroelastoma and stroke. Echocardiographic diagnosis and guide to excision. Am J Med. 1986;80:129–32. PubMed

Poterucha TJ, Kochav J, O’Connor DS, Rosner GF. Cardiac tumors: clinical presentation, diagnosis, and management. Curr Treat Options Oncol. 2019;20:66. PubMed

Rocha RV, Butany J, Cusimano RJ. Adipose tumors of the heart. J Card Surg. 2018;33:432–7. PubMed

Hoffmeier A, Sindermann JR, Scheld HH, Martens S. Cardiac tumors: diagnosis and surgical treatment. Dtsch Arztebl Int. 2014;111:205–11. PubMed PMC

Llombart-Cussac A, Pivot X, Contesso G, Rhor-Alvarado A, Delord JP, Spielmann M, Türsz T, Le Cesne A. Adjuvant chemotherapy for primary cardiac sarcomas: the IGR experience. Br J Cancer. 1998;78:1624–8. PubMed PMC

Bussani R, De-Giorgio F, Abbate A, Silvestri F. Cardiac metastases. J Clin Pathol. 2007;60:27–34. PubMed PMC