Aboelnazar Nader S, Loshusan Brandon R, Chu Michael W A
Division of Cardiac Surgery, Department of Surgery, Western University, London Health Sciences Centre, ON, Canada.
Schulich School of Medicine & Dentistry, London, ON, Canada.
Innovations (Phila). 2024 Sep-Oct;19(5):550-555. doi: 10.1177/15569845241289132. Epub 2024 Oct 29.
Primary cardiac tumors are uncommon, often benign, but can be potentially life threatening. Minimally invasive endoscopic (ENDO) techniques have been shown to be a feasible alternative for tumor resection compared with conventional sternotomy (CS). This study compared the clinical and surgical outcomes of a small series of patients undergoing cardiac tumor resection operations.
Between November 2009 and December 2022, 34 consecutive patients underwent cardiac tumor resection using either ENDO ( = 21) or CS ( = 13) techniques. We compared early perioperative outcomes, echocardiographic outcomes, and long-term clinical and tumor recurrence outcomes.
Baseline characteristics were similar between groups; however, the ENDO group included younger patients (56 ± 16 vs 62 ± 17 years) and more female patients (83% vs 53%). The tumor was located in the left atrium ( = 19, 56%), right atrium ( = 5, 15%), or either ventricle ( = 4, 12%). In-hospital mortality and stroke frequency were similar for both groups ( = 0). There was no significant difference in cardiopulmonary bypass or cross-clamp times, respiratory or renal failure, or intensive care unit or hospital lengths of stay. At follow-up (ENDO, 42 [2 to 131] months vs CS, 54 [1 to 156] months), there were no deaths in the ENDO group and 2 patients died in the CS group ( = 0.21). No patients in either group experienced tumor recurrence.
In selected patients, both ENDO and CS approaches to primary cardiac tumor resection were safe, effective, durable, and associated with similarly good early and late results.
原发性心脏肿瘤并不常见，通常为良性，但可能危及生命。与传统胸骨切开术（CS）相比，微创内镜（ENDO）技术已被证明是肿瘤切除的一种可行替代方法。本研究比较了一小系列接受心脏肿瘤切除手术患者的临床和手术结果。
2009年11月至2022年12月期间，34例连续患者采用ENDO（n = 21）或CS（n = 13）技术进行心脏肿瘤切除。我们比较了围手术期早期结果、超声心动图结果以及长期临床和肿瘤复发结果。
两组间基线特征相似；然而，ENDO组患者更年轻（56±16岁对62±17岁）且女性患者更多（83%对53%）。肿瘤位于左心房（n = 19，56%）、右心房（n = 5，15%）或任一心室（n = 4，12%）。两组的院内死亡率和中风发生率相似（均为0）。体外循环或阻断时间、呼吸或肾衰竭、重症监护病房或住院时间均无显著差异。随访时（ENDO组为42[2至131]个月，CS组为54[1至156]个月），ENDO组无死亡病例，CS组有2例患者死亡（P = 0.21）。两组均无患者出现肿瘤复发。
对于选定的患者，ENDO和CS两种原发性心脏肿瘤切除方法均安全、有效、持久，且早期和晚期结果同样良好。
