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J Thorac Cardiovasc Surg 2008;135:1061-1068
© 2008 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Analysis of benign ventricular tumors: Long-term outcome after resection

^a Harvard School of Public Health, Boston, Mass
^b Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minn

Received for publication August 28, 2007; revisions received October 11, 2007; accepted for publication October 19, 2007.

^_* Address for reprints: Andrew W. ElBardissi, BS, Harvard School of Public Health 677 Huntington Ave, Boston, MA 02115 (Email: delbardissi{at}partners.org).

Objective: We sought to compare clinical and pathologic characteristics of ventricular tumors and to detect whether differences exist in short- and long-term survival after resection.

Methods: From 1964 to 2005, 323 patients had cardiac surgery for resection of primary cardiac tumors; 53 (16%) patients had primary ventricular tumors. We randomly sampled 53 characteristics of ventricular tumors.

Results: Patients with ventricular tumors were younger than those with atrial tumors (34.8 vs 54.6 years; P < .0001). New York Heart Association functional status was similar at presentation, although patients with atrial tumors had increased risk of atrial fibrillation (P < .05), thromboembolic events (P = .04), and mitral stenosis (P = .008) at the time of presentation. Patients with ventricular tumors had an increased incidence of myocardial invasion (14% vs 2%; P = .02) and had significantly longer cardiopulmonary bypass (80 vs 65 minutes; P < .05) and crossclamp (52 vs 39 minutes; P = .03) times. Operative mortality was 4% and 0% in the ventricular and atrial groups, respectively (P = not significant). Follow-up was obtained in 89% of patients at a mean follow-up time of 7.21 years. A Kaplan–Meier survival plot demonstrated no difference in survival characteristics of both groups. At follow-up, 81% and 74% of ventricular and atrial tumors, respectively, were minimally symptomatic (New York Heart Association class I/II; P = .13). Patients with atrial and ventricular tumors had a 6% and 0% tumor recurrence rate, respectively (P = .12).

Conclusion: Surgical resection for ventricular tumors is effective and results in excellent long-term outcome. Early surgical treatment should be strongly considered in patients with primary ventricular tumors.