Lu Jin, Chen Yu, Lian Xingchen, Chang Peipei, Wen Ping, Zou Na, Ma Lin, Liu Yuhang
Department of Cardiovascular Surgery, Dalian Women and Children's Medical Group, Dalian, China.
Graduate School, Dalian Medical University, Dalian, China.
Front Cardiovasc Med. 2025 Apr 10;12:1492727. doi: 10.3389/fcvm.2025.1492727. eCollection 2025.
Primary cardiac tumors are extremely rare, with fibromas being one of the more prevalent type primary cardiac tumors in infants and children. Cardiac fibromas present a high risk of fatal arrhythmia and sudden death, hence more aggressive surgical treatment approaches are typically employed. However, certain populations, such as asymptomatic infants and young children in the early stages, require extra caution. We present the case of a patient with a giant fibroma of the heart detected during fetal development, who was followed up until the age of 5 months before undergoing surgical resection. Prior to surgery, we employed three-dimensional (3D) imaging technology to acquire a deeper understanding of the anatomical nature of cardiac tumors. We then devised a comprehensive surgical strategy to minimize the risk of damage to large blood vessels during surgery and maximize preservation of myocardial tissue. Following surgical resection of the tumor, cardiac dysfunction was managed with extracorporeal membrane oxygenation (ECMO) continuous adjuvant therapy, and conventional vasodilators such as dopamine and nitroglycerin were ad. The patient recovered well without any serious complications. This case highlights the significance of timely surgical intervention, combined with 3D imaging to develop a meticulous surgical plan and early use of ECMO to maintain cardiac function in patients with postoperative cardiac dysfunction. This can help to ensure the safety and effectiveness of giant cardiac fibromas resection in infants and young children.
原发性心脏肿瘤极为罕见，纤维瘤是婴幼儿中较为常见的原发性心脏肿瘤类型之一。心脏纤维瘤存在致命性心律失常和猝死的高风险，因此通常采用更积极的手术治疗方法。然而，某些人群，如早期无症状的婴幼儿，需要格外谨慎。我们报告一例在胎儿发育期间检测出巨大心脏纤维瘤的患者，在5个月龄前进行手术切除之前一直进行随访。手术前，我们采用三维（3D）成像技术，以更深入地了解心脏肿瘤的解剖性质。然后我们制定了全面的手术策略，以尽量减少手术期间对大血管的损伤风险，并最大限度地保留心肌组织。肿瘤手术切除后，采用体外膜肺氧合（ECMO）持续辅助治疗来处理心脏功能障碍，并加用多巴胺和硝酸甘油等传统血管扩张剂。患者恢复良好，未出现任何严重并发症。该病例强调了及时进行手术干预的重要性，结合3D成像制定细致的手术计划，以及早期使用ECMO来维持术后心脏功能障碍患者的心脏功能。这有助于确保婴幼儿巨大心脏纤维瘤切除手术的安全性和有效性。
