Pediatric Cardiac Tumors Follow-up
- Author: Edwin Rodriguez-Cruz, MD; Chief Editor: Steven R Neish, MD, SM more...
Further Inpatient Care
- Discharge patients with cardiac tumors when they are stable.
Further Outpatient Care
- Provide close follow-up care to diagnose recurrence of malignant tumors after resection.
- Monitor ventricular function.
- Monitor medication doses and effects.
Inpatient & Outpatient Medications
- Medications, when indicated, include digitalis, afterload reduction agents, diuretics, antiarrhythmics, and anticoagulants.
Transfer
- Transfer to a facility with the necessary specialties and consultants.
Complications
- Complications include arrhythmia, congestive heart failure (CHF), thromboembolism, decrease in ventricular function, and seeding during surgical removal (metastasis).
- For complications related to specific types of cardiac tumors, see Background.
Prognosis
- Studies provide a wide spectrum of morbidity and mortality statistics.
- Survival rates depend on the type of tumor.
- Benign tumors have a good prognosis unless they are associated with severe obstruction or intractable arrhythmias, which have a slightly higher risk of mortality.
- For primary cardiac malignant tumors, the prognosis is invariably poor.
- Metastatic neoplasms to the heart are more common than primary cardiac neoplasms; the prognosis is dependent on the histologic type of tumor, and survival rates are based on original pathology.
- Certain tumors are known to recur even after resection.
- Most children with cardiac tumors have an excellent prognosis and do not need any intervention.
Lam KY, Dickens P, Chan AC. Tumors of the heart. A 20-year experience with a review of 12,485 consecutive autopsies. Arch Pathol Lab Med. Oct 1993;117(10):1027-31. [Medline].
Miyake CY, Del Nido PJ, Alexander ME, Cecchin F, Berul CI, Triedman JK, et al. Cardiac tumors and associated arrhythmias in pediatric patients, with observations on surgical therapy for ventricular tachycardia. J Am Coll Cardiol. Oct 25 2011;58(18):1903-9. [Medline].
Kono T, Koide N, Hama Y, et al. Expression of vascular endothelial growth factor and angiogenesis in cardiac myxoma: a study of fifteen patients. J Thorac Cardiovasc Surg. Jan 2000;119(1):101-7. [Medline].
Beroukhim RS, Prakash A, 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. Aug 30 2011;58(10):1044-54. [Medline].
Grant FD, Treves ST. Nuclear medicine and molecular imaging of the pediatric chest: current practical imaging assessment. Radiol Clin North Am. Sep 2011;49(5):1025-51. [Medline].
Butany J, Nair V, Naseemuddin A, et al. Cardiac tumours: diagnosis and management. Lancet Oncol. Apr 2005;6(4):219-28. [Medline].
Dhillon G, Rodriguez-Cruz E, Kathawala M, Alqassem N. Primary cardiac myofibroblastic sarcoma, case report and review of diagnosis and treatment of cardiac tumors. Bol Asoc Med P R. Jul-Dec 1998;90(7-12):130-3. [Medline].
Farooki ZQ, Ross RD, Paridon SM, et al. Spontaneous regression of cardiac rhabdomyoma. Am J Cardiol. Apr 15 1991;67(9):897-9. [Medline].
Gaumann A, Strubel G, Bode-Lesniewska B, Schmidtmann I, Kriegsmann J, Kirkpatrick CJ. The role of tumor vascularisation in benign and malignant cardiovascular neoplasms: a comparison of cardiac myxoma and sarcomas of the pulmonary artery. Oncol Rep. Aug 2008;20(2):309-18. [Medline].
Le Guyader A, Laskar M. Removal of left ventricular tumors by a transaortic transvalvular approach with the help of thoracoscopic instruments. J Thorac Cardiovasc Surg. Aug 2008;136(2):537-8. [Medline].
Lopez M, Pinto A, Moreno V, Diaz M, Gonzalez Baron A. Primary cardiac osteosarcoma. Clin Transl Oncol. Aug 2008;10(8):515-6. [Medline].
Ludomirsky A. Cardiac tumors. In: Bricker JT, Fisher DJ, eds. The Science and Practice of Pediatric Cardiology. Vol 2. 9th ed. Williams & Wilkins; 1998:1885-93.
Martinez Quesada M, Trujillo Berraquero F, Almendro Delia M, et al. [Cardiac hamartoma. Case report and literature review]. Rev Esp Cardiol. Apr 2005;58(4):450-2. [Medline].
Marx GR. Cardiac Tumors. In: Emmanouilides GC, Gutgesell HP, Riemenschneider TA, Allen HD, eds. Moss and Adams Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult. Vol 2. 5th ed. Baltimore, MD: Williams & Wilkins; 1995:1773-86.
McAllister HA, Fenoglio JJ Jr. Tumors of the cardiovascular system: atlas of tumor pathology, second series. In: Washington, DC: Armed Forces Institute of Pathology. 1978.
Padalino MA, Basso C, Milanesi O, et al. Surgically treated primary cardiac tumors in early infancy and childhood. J Thorac Cardiovasc Surg. Jun 2005;129(6):1358-63. [Medline].
Piazza N, Chughtai T, Toledano K, et al. Primary cardiac tumours: eighteen years of surgical experience on 21 patients. Can J Cardiol. Dec 2004;20(14):1443-8. [Medline].
Rodriguez-Cruz E, Cintron-Maldonado RM, Bercu BA. Primary cardiac osteogenic sarcoma treated with heart transplantation. Bol Asoc Med PR. 1999;91 (7-12):98-99. [Medline].
Rodriguez-Cruz E, Cintron-Maldonado RM, Forbes TJ. Treatment of primary cardiac malignancies with orthotopic heart transplantation. Bol Asoc Med P R. Apr-Aug 2000;92(4-8):65-71. [Medline].
Takach TJ, Reul GJ, Ott DA, Cooley DA. Primary cardiac tumors in infants and children: immediate and long-term operative results. Ann Thorac Surg. Aug 1996;62(2):559-64. [Medline].
Tatli S, Lipton MJ. CT for intracardiac thrombi and tumors. Int J Cardiovasc Imaging. Feb 2005;21(1):115-31. [Medline].
Tazelaar HD, Locke TJ, McGregor CG. Pathology of surgically excised primary cardiac tumors. Mayo Clin Proc. Oct 1992;67(10):957-65. [Medline].
Wu XM, Hu CZ, Li N, et al. [Relationship of serum level of creatine kinase of MB type to cardiac function of patients with advanced tumors and its prognostic value]. Ai Zheng. Apr 2005;24(4):506-8.abs. [Medline].

