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J Thorac Cardiovasc Surg 2007;133:254-255
© 2007 The American Association for Thoracic Surgery

Brief Communication

Surgical management of symptomatic cardiac fibromas in children

^a Cardiac Surgical Unit, Royal Children’s Hospital, Melbourne, Australia
^b Department of Paediatrics, University of Melbourne, Melbourne, Australia.

Received for publication September 13, 2006; accepted for publication September 19, 2006.

^_* Address for reprints: Ben Davies, MRCS(Eng), Cardiac Surgical Unit, Royal Children’s Hospital, Flemington Rd, Melbourne VIC 3052, Australia. (Email: ben.davies@mcri.edu.au).

The first 20% of the full text of this article appears below.

Cardiac fibromas have the second highest incidence of primary cardiac tumors in children after rhabdomyomas but are the most commonly resected.¹ In contrast to rhabdomyomas, fibromas are usually large, solitary, intramural tumors with a predilection for the left ventricular free wall or interventricular septum² and tend not to regress spontaneously. They may be asymptomatic or present with arrhythmias or cardiac failure due to chamber obliteration and valvular obstruction.¹ We describe 2 cases in which resection and reconstruction of giant intramural cardiac fibromas involving the atrioventricular (AV) groove was possible without resorting to mechanical circulatory support or transplantation.

Clinical Summary

PATIENT 1. A 3-day-old boy (3.5 kg) presented with cyanosis and cardiac failure shortly after birth. Preoperative evaluation with echocardiography and computed tomography demonstrated a 7-cm mass involving the anterior aspect of the right atrium and right ventricular (RV) outflow free wall, resulting in compromise of the RV cavity and intermittent obstruction of both caval inflow and RV outflow.

At operation, the hourglass-shaped tumor was found to . . . [Full Text of this Article]