Primary cardiac valve tumors: early and late results of surgical treatment in 10 patients.

BACKGROUND: Our goal was to study the clinical characteristics of primary valve tumors and the late surgical results of their resection.

METHODS: We reviewed our clinical experience with the surgical treatment of ten primary valve tumors at Fu Wai Hospital over the past 19 years. During that time, cardiac valve tumors accounted for 2.65% of all primary cardiac tumors at our hospital, and the incidence of primary valve tumors was roughly one in 4,000 cardiac operations. There were 5 male and 5 female patients aged 2 to 66 years (mean age, 30.1 years). The clinical presentation included exertional dyspnea in 7 patients, neurological symptoms in 2, and cyanosis at rest in 1 patient. The diagnosis was established by preoperative echocardiography in 8 patients, and in the other 2, it was confirmed by the findings at operation. All of the tumors were resected. Eight of the ten tumors were benign, and two were malignant.

RESULTS: All patients survived the operation and recovered uneventfully. Late outcomes were known for all patients. There were three late deaths. One patient with a benign tricuspid valve tumor died 2 months postoperatively of an electrolyte disorder. The other 2 patients with a malignant mitral valve tumor died within 1 year postoperatively. The 7 survivors, all with a benign valve tumor, were followed for an average of 5.7 years (range, 8 months to 19 years), and all were in functional class I. Exercise tolerance improved to normal levels. The latest follow-up echocardiograms showed no evidence of local recurrence in any patient.

CONCLUSIONS: Excellent early and late surgical results can be obtained in patients with benign valve tumors. The prognosis for patients with a malignant valve tumor is poor.