Surgery for cardiac tumours: the University of Ottawa Heart Institute experience (1980-91).

OBJECTIVE: To review the University of Ottawa Heart Institute's experience with surgery for cardiac tumours. Case series of all patients who had surgical exploration of cardiac tumours from 1980-91 inclusive. Hospital charts, surgical pathology reports, gross photographs and glass microscopic slides were reviewed in each case.

SETTING: Tertiary care, specialized cardiac referral centre.

PATIENTS: All patients were diagnosed and treated surgically for heart tumours at the University of Ottawa Heart Institute over the 11-year period. The group consisted of 29 adults (14 male, 15 female) aged 15 to 76 years (mean 48) and one male newborn (six days old). Follow-up was available in 24 of 30 cases and averaged three years and four months (range four days to seven years).

RESULTS: Twenty-six patients had primary cardiac tumours; 24 were benign (18 myxomas and seven nonmyxomas [one patient with lipomatous hypertrophy had coexistent myxoma]) and two were malignant. Four patients had involvement of the heart by tumours elsewhere: one benign and three malignant. Twenty-two of 24 benign primary tumours were resected successfully with relief of symptoms; two tumours were not resectable. None of the resected benign tumours recurred. Both patients with malignant primary tumours died from their disease. Three of the four patients with tumours arising elsewhere died, while the patient with benign hepatic vein leiomyoma extending into the heart remains well.

CONCLUSIONS: Therefore, surgical resection of benign cardiac tumours, whether primary or secondary, is safe and usually curative. Surgery for malignant tumours is diagnostic at best.