Serie de pacientes operados de masas y quistes cardíacos en un hospital general de Españauna experiencia de 20 años

  1. Gil-Korilis, Adrián 1
  2. Esquíroz-Patiño, Claudia 1
  3. Llamas-Llamazares, Aroa 1
  4. Manrique, Rebeca 2
  5. Diaz-Dorronsoro, Agnes 2
  1. 1 Universidad de Navarra. Facultad de Medicina. Pamplona. Navarra. España.
  2. 2 Clínica Universidad de Navarra. Departamento de Cardiología y Cirugía Cardiaca. Pamplona. Navarra. España.
Revista:
Anales del sistema sanitario de Navarra

ISSN: 1137-6627

Any de publicació: 2023

Volum: 46

Número: 3

Pàgines: 41-50

Tipus: Article

DOI: 10.23938/ASSN.1060 DIALNET GOOGLE SCHOLAR lock_openAccés obert editor

Altres publicacions en: Anales del sistema sanitario de Navarra

Resum

Background. Masses and cysts in the heart are well-known entities, but their low prevalence and non-specific symptoms makes the diagnosis difficult. We aimed to characterize the features of these entities in our environment. Methods. We carried out a search of patients who underwent surgery for tumors and cysts in the heart between 2002 and 2022 in the registry of the Department of Cardiology and Cardiac Surgery of Clínica Universidad de Navarra (Pamplona, Spain). Sociodemographic, clinical, histological, and surgical variables were collected. Results. We identified 13 patients; mean age was 63.08 ± 15.17 years, 76.92% were female and 92.31% had at least one cardiovascular risk factor, e.g., BMI ≥ 25 kg/m2 and high blood pressure (61.54% and 53.85%, respectively). The most common type of cardiac tumors were myxomas (69.23%). Around half (46.15%) were incidental; the most frequent symptom was dyspnea (53.85%); 30.77% of the patients were asymptomatic. The most commonly used imaging technique for the diagnosis was transthoracic Doppler echocardiography (69.23%). The agreement between the mean diameters before and after surgery was very high (ICC = 0.807, 95% CI: 0.450 - 0.943). Conclusions. We describe the features of masses and cysts in the heart (77% female patients) and provide information scarcely available in the literature, e.g., the most frequent cardiovascular risk factors for this population. A case of cardiac leiomyosarcoma and a case of intimal sarcoma of the pulmonary trunk are described, two extremely rare tumors for which there are few described cases.

Referències bibliogràfiques

  • IMAZIO M, ANDRIANI M, LOBETTI BODONI L, GAITA F. Masses and tumours. En: IMAZIO M, ANDRIANI M, LOBETTI BODONI L, GAITA F, editors. Learning cardiac magnetic resonance : a case-based guide. Springer International Publishing; 2019: 145-153. http://doi.org/10.1007/978-3-030-11608-8_10
  • CRESTI A, CHIAVARELLI M, GLAUBER M, TANGANELLI P, SCALESE M, CESAREO F et al. Incidence rate of primary cardiac tumors: a 14-year population study. J Cardiovasc Med 2016; 17(1): 37-43. http://doi.org/10.2459/JCM.0000000000000059
  • AWTRY EH. Atrial myxoma and other cardiac tumors. En: LOSCALZO J, FAUCI A, KASPER D, HAUSER S, LONGO D, JAMESON JL, editores. Harrison’s Principles of Internal Medicine. 21ª ed. Nueva York: McGraw-Hill Education, 2022.
  • SULTAN I, BIANCO V, HABERTHEUER A, KILIC A, GLEASON TG, ARANDA-MICHEL E et al. Long-term outcomes of primary cardiac malignancies: multi-institutional results from the National Cancer Database. J Am Coll Cardiol 2020; 75(18): 2338-2347. http://doi.org/10.1016/j.jacc.2020.03.041
  • TYEBALLY S, CHEN D, BHATTACHARYYA S, MUGHRABI A, HUSSAIN Z, MANISTY C et al. Cardiac tumors: JACC cardiooncology state-of-the-art review. JACC CardioOncol 2020; 2(2): 293-311. http://doi.org/10.1016/j.jaccao.2020.05.009
  • POTERUCHA TJ, KOCHAV J, O’CONNOR DS, ROSNER GF. Cardiac tumors: Clinical presentation, diagnosis, and management. Curr Treat Options Oncol 2019; 20(8): 66. http://doi.org/10.1007/s11864-019-0662-1
  • YANAGAWA B, MAZINE A, CHAN EY, BARKER CM, GRITTI M, REUL RM et al. Surgery for tumors of the heart. Semin Thorac Cardiovasc Surg 2018; 30(4): 385-397. http://doi.org/10.1053/j.semtcvs.2018.09.001
  • LYON AR, LÓPEZ-FERNÁNDEZ T, COUCH LS, ASTEGGIANO R, AZNAR MC, BERGLER-KLEIN J et al. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J 2022; 43(41): 4229-4361. http://doi.org/10.1093/eurheartj/ehac244
  • REYNEN K. Cardiac myxomas. N Engl J Med 1995; 333(24): 1610-1617. http://doi.org/10.1056/NEJM199512143332407
  • BRUCE CJ. Cardiac tumours: diagnosis and management. Heart 2011; 97(2): 151. http://doi.org/10.1136/hrt.2009.186320
  • ISLAM AKMM. Cardiac myxomas: A narrative review. World J Cardiol 2022; 14(4): 206-219. http://doi.org/10.4330/wjc.v14.i4.206
  • NASER N, HADZIOMEROVIC N, BAHRAM D, KACILA M, PANDUR S. Giant right atrial myxoma with symptoms of right heart failure. Med Arch 2021; 75(1): 66. http://doi.org/10.5455/medarh.2021.75.66-68
  • LICHTENBERGER JP, DULBERGER AR, GONZALES PE, BUENO J, CARTER BW. MR imaging of cardiac masses. Top Magn Reson 2018; 27(2): 103-111. http://doi.org/10.1097/RMR.0000000000000166
  • YANG M, YAO M, WANG G, XIAO C, WU Y, ZHANG H et al. Comparison of postoperative quality of life for patients who undergo atrial myxoma excision with robotically assisted versus conventional surgery. J Thorac Cardiovasc Surg 2015; 150(1): 152-157. http://doi.org/10.1016/j.jtcvs.2015.01.056
  • BLONDEAU P. Primary cardiac tumors - French studies of 533 cases. Thorac Cardiovasc Surg 1990; 38(S 2): 192-195. http://doi.org/10.1055/s-2007-1014065
  • Ministerio de Sanidad. Gobierno de España. Catálogo Nacional de Hospitales. Consultado el 19 de mayo de 2023. https://www.sanidad.gob.es/ciudadanos/prestaciones/centrosServiciosSNS/hospitales/docs/CNH_2022.pdf
  • BUSSANI R, DE-GIORGIO F, ABBATE A, SILVESTRI F. Cardiac metastases. J Clin Pathol 2007; 60(1): 27. http://doi.org/10.1136/jcp.2005.035105
  • MALESZEWSKI JJ, BOIS MC, BOIS JP, YOUNG PM, STULAK JM, KLARICH KW. Neoplasia and the heart: Pathological review of effects with clinical and radiological correlation. J Am Coll Cardiol 2018; 72(2): 202-227. http://doi.org/10.1016/j.jacc.2018.05.026
  • MANGLA A, YADAV U. Leiomyosarcoma. En: Statpearls. Treasure Island (FL): StatPearls Publishing, 2022.
  • BABATASI G, MASSETTI M, AGOSTINI D, GALATEAU F, LE PAGE O, SALOUX E et al. Leiomyosarcoma of the heart and great vessels. Ann Cardiol Angeiol 1998; 47(7): 451-458. http://www.ncbi.nlm.nih.gov/pubmed/9772966
  • CHAN EY, RAVI V, ALI A, HGUYEN DT, GRAVISS EA, MACGILLIVRAY TE et al. Surgical management of primary pulmonary artery sarcoma. Semin Thorac Cardiovasc Surg 2023; 35(1): 53-64. http://doi.org/10.1053/j.semtcvs.2021.10.013
  • SAMANIDIS G, KHOURY M, BALANIKA M, PERREA DN. Current challenges in the diagnosis and treatment of cardiac myxoma. Kardiol Pol 2020; 78(4): 269-277. http://doi.org/10.33963/KP.15254
  • OLIVEIRA GH, AL-KINDI SG, HOIMES C, PARK SJ. Characteristics and survival of malignant cardiac tumors. CIRC. 2015; 132(25): 2395-2402. http://doi.org/10.1161/Circulationaha.115.016418
  • PÉREZ ANDREU J, PARRILLA G, ARRIBAS JM B, GARCÍA-VILLALBA B, LUCAS JJ, GARCIA NAVARRO M et al. Neurological manifestations of cardiac myxoma: Experience in a referral hospital. Neurología 2013; 28(9): 529-534. http://doi.org/10.1016/j.nrleng.2013.10.016
  • ZUWASTI U, QUARRIE R, ALLEN E, HAAS C. Severe functional mitral stenosis due to a left atrial myxoma masquerading as asthma. BMJ Case Rep 2020; 13(12): e236876. http://doi.org/10.1136/bcr-2020-236876
  • PINEDE L, DUHAUT P, LOIRE R. Clinical presentation of left atrial cardiac myxoma: A series of 112 consecutive cases. Medicine 2001; 80(3): 159-172. http://doi.org/10.1097/00005792-200105000-00002
  • OBEID AI, MARVASTI M, PARKER F, ROSENBERG J. Comparison of transthoracic and transesophageal echocardiography in diagnosis of left atrial myxoma. Am J Cardiol 1989; 63(13): 1006-1008. http://doi.org/10.1016/0002-9149(89)90162-8
  • ENGBERDING R, DANIEL WG, ERBEL R, KASPER W, LESTUZZI C, CURTIUS JM et al. Diagnosis of heart tumours by transoesophageal echocardiography: a multicentre study in 154 patients. Eur Heart J 1993; 14(9): 1223-1228. http://doi.org/10.1093/eurheartj/14.9.1223
  • BEROUKHIM RS, PRAKASH A, VALSANGIACOMO BUECHEL ER, CAVA JR, DORFMAN AL, FESTA P et al. Characterization of cardiac tumors in children by cardiovascular magnetic resonance imaging: a multicenter experience. J Am Coll Cardiol 2011; 58(10): 1044-1054. http://doi.org/10.1016/j.jacc.2011.05.027
  • D’ANGELO EC, PAOLISSO P, VITALE G, FOÀ A, BERGAMASCHI L, MAGNANI I et al. Diagnostic accuracy of cardiac computed tomography and 18-F fluorodeoxyglucose positron emission tomography in cardiac masses. JACC Cardiovasc Imaging 2020; 13(11): 2400-2411. http://doi.org/10.1016/j.jcmg.2020.03.021
  • SCHEFFEL H, BAUMUELLER S, STOLZMANN P, LESCHKA S, PLASS A, ALKADHI H et al. Atrial myxomas and thrombi: Comparison of imaging features on CT. AJR Am J Roentgenol 2009; 192(3): 639-645. http://doi.org/10.2214/AJR.08.1694
  • Shin W, Choe YH, Kim SM, Song IY, Kim SS. Detection of cardiac myxomas with non-contrast chest CT. Acta radiol 2014; 55(3): 273-278. http://doi.org/10.1177/0284185113496561
  • CARNEY JA, HRUSKA LS, BEAUCHAMP GD, GORDON H. Dominant inheritance of the complex of myxomas, spotty pigmentation, and endocrine overactivity. Mayo Clin Proc 1986; 61(3): 165-172. http://doi.org/10.1016/S0025-6196(12)61843-6
  • LEE SH, PARK JS, PARK JH, CHIN JY, YOON WS, KIM HY et al. Comparison of clinical and echocardiographic characteristics between cardiac myxomas and masses mimicking myxoma. Korean Circ J 2020; 50(9): 822. http://doi.org/10.4070/kcj.2020.0024
  • HILL M, CHERRY C, MALONEY M, MIDYETTE P. Surgical resection of atrial myxomas. AORN J 2010; 92(4): 393-409. https://doi.org/10.1016/j.aorn.2010.06.012
  • SCHAFF H V, MULLANY CJ. Surgery For Cardiac Myxomas. Semin Thorac Cardiovasc Surg 2000; 12(2): 77-88. http://doi.org/10.1053/ct.2000.5079
  • PAPADOPOULOS K, ALEXIOU C, OZDEN TOK O, VANNAN MA. Intraoperative embolism of a right atrial myxoma: a case report. Eur Heart J Case Rep 2020; 4(6): 1-4. http://doi.org/10.1093/ehjcr/ytaa476
  • LIN Y, XIAO J, CHEN J, HONG J, PENG H, KANG B et al. Treating cardiac myxomas: a 16-year Chinese single-center study. J Cardiovasc Med 2016; 17(1): 44-53. http://doi.org/10.2459/JCM.0000000000000114
Fuente de los datos: Dialnet