ABSTRACT
Seven patients with malignant cardiac tumors were treated surgically in the Department of Cardiothoracic Surgery of the University of Tokyo between 1981 and 2000. Their treatments and outcomes are summarized and discussed. The ages of the patients ranged from 21 to 70 years old (mean: 49.5+/-15) and there were three males and four females. The histopathological diagnoses were hepatocellular carcinoma (HCC), spindle cell sarcoma, round cell sarcoma, osteosarcoma, renal cell carcinoma, and leiomyosarcoma. In four of the cases, the tumor extended or metastasized from other organs, while in the other three cases it originated in the heart. Before the cardiac operation, an above-knee amputation, left nephrectomy, transarterial embolization, or extended right hepatic lobectomy had been performed to treat the primary site of the tumor. Tumor resection using cardiopulmonary bypass was performed in every case. The NYHA classification of heart failure was significantly improved (preop: 3.3+/-0.8, postop: 1.9+/-0.7 [P<0.001]). The mean survival period of the patients who died was 8.8+/-7.0 months. A patient with renal cell carcinoma is still alive after 87 months of follow-up. In summary, surgical treatment of malignant tumors of the right heart can improve the QOL in patients with cardiac failure. However, its effectiveness was temporary in all cases except one case of renal cell carcinoma.
Subject(s)
Cardiac Surgical Procedures/methods , Cardiopulmonary Bypass , Heart Neoplasms/surgery , Adult , Aged , Carcinoma/secondary , Carcinoma/surgery , Carcinoma, Hepatocellular/secondary , Carcinoma, Hepatocellular/surgery , Female , Follow-Up Studies , Heart Neoplasms/pathology , Humans , Kidney Neoplasms/secondary , Leiomyosarcoma/surgery , Liver Neoplasms/secondary , Male , Middle Aged , Neoplastic Cells, Circulating , Osteosarcoma/secondary , Osteosarcoma/surgery , Prognosis , Retrospective Studies , Sarcoma, Small Cell/secondary , Sarcoma, Small Cell/surgeryABSTRACT
A 15-year-old girl developed subacute constrictive pericarditis following successful surgical repair of double-chambered right ventricle. Two weeks after surgery, the patient had massive pericardial effusion, which acutely progressed to constrictive pericarditis with the symptoms of cardiac tamponade. Further surgery was necessary to resect the parietal pericardium. No blood transfusion was required for this patient, who was a Jehovah's Witness. She was doing well 9 months after the second operation, with residual pericardium of normal thickness.
