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Karigyo CJT, Pessoa BMS, Nicacio SP, Terwilliger E, Costa P, dos Santos PR, Ernani V, Seetharam M, Murakami AN, Batalini F. Cardiac Tumors: Review. Braz J Cardiovasc Surg 2024; 39:e20230405. [PMID: 39038269 PMCID: PMC11262154 DOI: 10.21470/1678-9741-2023-0405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/12/2024] [Indexed: 07/24/2024] Open
Abstract
Cardiac tumors are rare and encompass a variety of presentations. Clinica symptoms are usually nonspecific, but they can present as obstructive, embolic, or constitutional symptoms. Treatment options and prognosis vary highly depending on the subtype, tumor size, and location. Surgical resection is usually the first-line therapy, except for cardiac lymphomas, and provides favorable long-term prognosis in most benign tumors. Cardiac sarcomas, however, are usually diagnosed in advanced stages, and the treatment relies on a multimodal approach with chemotherapy and radiotherapy. Metastatic cardiac tumors are usually related to advanced disease and carry an overall poor prognosis.
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Affiliation(s)
- Carlos J. T. Karigyo
- Engineering Center for Circulatory Assistance, Instituto Dante
Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil
- Postgraduate Program in Medicine/Technology and Intervention in
Cardiology, Universidade de São Paulo, São Paulo, São Paulo,
Brazil
| | | | | | - Emma Terwilliger
- Mayo Clinic College of Medicine and Science, Rochester, Minnesota,
United States of America
| | - Philippos Costa
- Division of Hematology and Oncology, Yale University Yale Cancer
Center, New Haven, Connecticut, United States of America
| | - Pedro Reck dos Santos
- Division of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix,
Arizona, United States of America
| | - Vinicius Ernani
- Division of Oncology, Mayo Clinic Arizona, Phoenix, Arizona, United
States of America
| | - Mahesh Seetharam
- Division of Oncology, Mayo Clinic Arizona, Phoenix, Arizona, United
States of America
| | | | - Felipe Batalini
- Division of Oncology, Mayo Clinic Arizona, Phoenix, Arizona, United
States of America
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Honda R, Nakao Y, Masuda Y, Ohshima K, Koike S, Kono T, Ogimoto A. Isolated Massive Metastatic Tumor of the Right Ventricle and Pulmonary Artery With Disseminated Intravascular Coagulation in the Distant Period of Cervical Cancer. Circ J 2024; 88:435. [PMID: 38191173 DOI: 10.1253/circj.cj-23-0844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Affiliation(s)
| | - Yasuhisa Nakao
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine
| | - Yuya Masuda
- Division of Hematology, Uwajima City Hospital
| | | | - Shota Koike
- Division of Cardiology, Uwajima City Hospital
| | - Tamami Kono
- Division of Cardiology, Uwajima City Hospital
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Riad M, Rahman MU, Mulyala R, Sayyed N, Bayer D, Omar B. Percutaneous Intracardiac Mass Extraction in High Surgical-Risk Patients. J Med Cases 2023; 14:362-368. [PMID: 38029057 PMCID: PMC10681765 DOI: 10.14740/jmc4150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
Large intracardiac masses including tumors, thrombi, and vegetations result in detrimental embolic or obstructive sequelae and present a management dilemma. Open heart surgery, the traditional approach, may not be an option for many patients with a prohibitive surgical risk due to multiple comorbidities. Recently, percutaneous options have emerged with reported success in extracting such intracardiac masses. A 42-year-old female with history of advanced primary sclerosing cholangitis with decompensated liver cirrhosis causing ascites and variceal bleed presented to the emergency department with fatigue, subjective fevers, chills and melena. Laboratory results revealed neutrophil-predominant leukocytosis and normocytic anemia, and blood cultures were positive for Candida albicans. Electrocardiography showed sinus tachycardia. Chest X-ray was unremarkable. She underwent packed red blood cell transfusion and esophageal banding for variceal bleeding. Transthoracic echocardiogram revealed normal left ventricular ejection fraction and no wall motion abnormalities. A right atrial mobile mass measuring approximately 1.0 × 3.0 cm was noted. Multidisciplinary heart team discussion concluded that while the mass posed a high embolic risk, the patient had a prohibitive risk for surgical intervention. Successful percutaneous removal of the mass using Penumbra system device (Penumbra Incorporated, Alameda, CA) was accomplished. This case report details the procedure and outcomes, as well as presents a literature review.
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Affiliation(s)
- Mariam Riad
- Cardiology Division, University of South Alabama, Mobile, AL 36617, USA
| | | | | | - Nadia Sayyed
- Department of Internal Medicine, Khyber Medical College, Peshawar, Pakistan
| | - Danielle Bayer
- Cardiology Division, University of South Alabama, Mobile, AL 36617, USA
| | - Bassam Omar
- Cardiology Division, University of South Alabama, Mobile, AL 36617, USA
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Xu K, Ma Z, Li B, Wang Z, Song H, Bai X, Meng X, Liu K, Zhao X. Totally thoracoscopic surgical resection of left ventricular benign tumor. JTCVS Tech 2023; 20:116-122. [PMID: 37555023 PMCID: PMC10405254 DOI: 10.1016/j.xjtc.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE The study objective was to explore the feasibility and safety of totally endoscopic resection of a left ventricular tumor through small chest incisions without robotic assistance. METHODS Four patients with a left ventricular tumor (1 papillary fibroelastoma, 1 lipoma, and 2 myxomas) underwent surgery with peripheral cardiopulmonary bypass. The mean age of patients was 58 ± 15 years. There were 3 female patients and 1 male patient. Through 3-port incisions in the right chest, pericardiotomy, bicaval cannulation, cardiac arrest, and atriotomy, left ventricular tumor resection was performed under thoracoscopy. RESULTS All patients had successful resections. The cardiopulmonary bypass and aortic crossclamp times were 110 ± 14 minutes and 58 ± 19 minutes, respectively. The length of stay in the intensive care unit was 38 ± 27 hours. There were no mortalities or complications in this cohort. Patients were discharged 7 days after the operation. Transthoracic echocardiography showed that the cardiac tumor was completely removed without any residue 3 months after surgery. CONCLUSIONS Totally endoscopic left ventricular tumor resection without a robotically assisted surgical system is feasible and reproducible. This technique could minimize surgical trauma and achieves complete tumor resection.
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Affiliation(s)
- Kai Xu
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Zengshan Ma
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Bowen Li
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Zhenhua Wang
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Han Song
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Xiao Bai
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Xiangbin Meng
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Kai Liu
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
| | - Xin Zhao
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Shandong, China
- Institute of Thoracoscopy in Cardiac Surgery, Shandong University, Shandong, China
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Rodrigues H, Ramalho AR, Correia I, Ferreira R, Santos L. Primary Cardiac Tumor in the Left Atrium: A Diagnostic Challenge. Cureus 2023; 15:e39443. [PMID: 37378158 PMCID: PMC10292095 DOI: 10.7759/cureus.39443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
An elderly man presented to the emergency department with shortness of breath, peripheral edema, and significant weight loss. Blood tests revealed anemia and elevated inflammatory markers, and chest imaging showed a massive left pleural effusion. During hospitalization, he developed subacute cardiac tamponade, and pericardiocentesis was performed. Further imaging revealed a primary malignant cardiac tumor with extensive infiltration of the cardiac tissue, and biopsy was deemed impossible due to the tumor's location. The most likely diagnosis was angiosarcoma. The cardiac surgery team evaluated the case and considered it inoperable due to the tumor's extensive infiltration. The patient is currently under the regular care of a palliative care team. This case underscores the difficulties of diagnosing primary cardiac tumors, particularly in elderly patients with comorbidities. Despite advances in imaging and surgical techniques, the prognosis for malignant cardiac tumors remains poor.
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Affiliation(s)
- Helena Rodrigues
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
| | - Ana Rita Ramalho
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
| | - Isabel Correia
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
| | - Rogério Ferreira
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
| | - Lèlita Santos
- Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
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Pasternack DM, Sharma M, Colavito J, Ramirez MM, Martinez MJ, Chakravarti S, Mosca R, Susheel Kumar TK. Neonatal Myxomas: Case Report and Literature Review. World J Pediatr Congenit Heart Surg 2022; 13:770-776. [DOI: 10.1177/21501351221126094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Myxomas are rare tumors in neonates and tend to have a different presentation compared to adults. We present an infant with a left atrial myxoma presenting with episodic tachycardia who underwent successful surgical excision. In addition, we performed a review of the literature, identifying 17 cases of neonatal myxomas. Unlike adults, neonatal myxomas are more common in males and occur more often on the right side of the heart. Constitutional symptoms such as fever or embolism are rare among neonates. Most patients have favorable outcomes following surgical excision, refuting earlier claims that neonatal myxomas are associated with poor outcomes.
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Affiliation(s)
- Daniel M Pasternack
- Department of Pediatrics (Cardiology), Hassenfeld Children’s Hospital at New York University Langone Medical Center, New York, NY, USA
| | - Madhu Sharma
- Department of Pediatrics (Cardiology), Children’s Hospital at Montefiore, Bronx, NY, USA
- Department of Pediatrics (Pediatric Cardiology), Albert Einstein College of Medicine, Bronx, NY, USA
| | - John Colavito
- Department of Pathology, New York University Langone Medical Center, New York, NY, USA
| | - Michelle M Ramirez
- Department of Pediatrics (Cardiology), Hassenfeld Children’s Hospital at New York University Langone Medical Center, New York, NY, USA
| | - Michael J Martinez
- Department of Pediatrics (Cardiology), Hassenfeld Children’s Hospital at New York University Langone Medical Center, New York, NY, USA
| | - Sujata Chakravarti
- Department of Pediatrics (Cardiology), Hassenfeld Children’s Hospital at New York University Langone Medical Center, New York, NY, USA
| | - Ralph Mosca
- Department of Pediatrics (Cardiology), Hassenfeld Children’s Hospital at New York University Langone Medical Center, New York, NY, USA
- Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, NY, USA
| | - TK Susheel Kumar
- Department of Pediatrics (Cardiology), Hassenfeld Children’s Hospital at New York University Langone Medical Center, New York, NY, USA
- Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, NY, USA
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Tian L, Liu M, He L, Zhang Q, Li Q, Zhang H. Cardiac metastasis from small cell lung cancer origin: A case report and review of the literature. Cancer Rep (Hoboken) 2022; 5:e1711. [PMID: 36117246 PMCID: PMC9675357 DOI: 10.1002/cnr2.1711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Cardiac metastasis from small cell lung cancer (SCLC) origin is rare, whereas the incidence is anticipated to increase with the extended survival rates. CASE We here describe a case report of a 48-year-old male patient diagnosis with SCLC in 2020. In June 2021, he resorted to hospital due to shortness of breath, no obvious changes were found in repeated echocardiography, electrocardiogram and chest computer tomography from June 2021 to September 2021. Due to the persistence of the complaints, cardiac magnetic resonance (CMR) imaging was performed in September 30th, 2021, which showed a mass in the right atrioventricular groove. The patient underwent pericardiocentesis and small cell carcinoma cells were found in the pericardial effusion, confirming the diagnosis of cardiac metastasis. CONCLUSION Patients with a history of SCLC who develop new cardiac symptoms of unknown etiology should undergo imaging studies such as CMR. The importance of CMR for patients with SCLC is highlighted. The literature regarding metastatic cardiac tumors is reviewed.
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Affiliation(s)
- Lei Tian
- The Fifth Department of OncologyHebei General HospitalShijiazhuangHebeiChina
| | - Miaomiao Liu
- The Fifth Department of OncologyHebei General HospitalShijiazhuangHebeiChina
| | - Liya He
- The Fifth Department of OncologyHebei General HospitalShijiazhuangHebeiChina
| | - Qi Zhang
- The Fifth Department of OncologyHebei General HospitalShijiazhuangHebeiChina
| | - Qiaofang Li
- The Fifth Department of OncologyHebei General HospitalShijiazhuangHebeiChina
| | - Hongzhen Zhang
- The Fifth Department of OncologyHebei General HospitalShijiazhuangHebeiChina
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The Interventricular Septum: Structure, Function, Dysfunction, and Diseases. J Clin Med 2022; 11:jcm11113227. [PMID: 35683618 PMCID: PMC9181036 DOI: 10.3390/jcm11113227] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/25/2022] [Accepted: 06/04/2022] [Indexed: 02/05/2023] Open
Abstract
Vertebrates developed pulmonary circulation and septated the heart into venous and arterial compartments, as the adaptation from aquatic to terrestrial life requires more oxygen and energy. The interventricular septum (IVS) accommodates the ventricular portion of the conduction system and contributes to the mechanical function of both ventricles. Conditions or diseases that affect IVS structure and function (e.g., hypertrophy, defects, other) may lead to ventricular pump failure and/or ventricular arrhythmias with grave consequences. IVS structure and function can be evaluated today using current imaging techniques. Effective therapies can be provided in most cases, although definitions of underlying etiologies may not always be easy, particularly in the elderly due to overlap between genetic and acquired causes of IVS hypertrophy, the most common being IVS abnormality. In this review, state-of-the-art information regarding IVS morphology, physiology, physiopathology, and disease is presented.
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