Management of primary cardiac paraganglioma
| Autor: | Juan P. Umana, Duc T. Nguyen, Edward A. Graviss, Michael J. Reardon, Edward Y. Chan, Areeba Ali, Thomas E. MacGillivray, Vinod Ravi, Dale J. Hamilton |
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| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Heart Neoplasms Paraganglioma 03 medical and health sciences 0302 clinical medicine Interquartile range medicine.artery medicine Humans Heart Atria Retrospective Studies Intra-aortic balloon pump Paraganglioma Extra-Adrenal Aorta medicine.diagnostic_test business.industry Cardiac Paraganglioma Magnetic resonance imaging medicine.disease Surgery 030228 respiratory system Pulmonary artery Patent foramen ovale Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 164:158-166.e1 |
| ISSN: | 0022-5223 |
| Popis: | Objective Cardiac paraganglioma is a rare tumor that most surgeons have limited experience treating. The objective of this study is to examine the management and outcomes for cardiac paraganglioma treatment when cared for by a multidisciplinary cardiac tumor team. Methods We reviewed our institutionally approved cardiac tumor database from March 2004 to June 2020 for cardiac paraganglioma. These prospectively collected data were retrospectively reviewed. Patient characteristics were presented for individual patients and as summary statistics. Demographic and clinical data were also reported as median and interquartile range for continuous variables and frequencies and proportions for categoric variables. Kaplan–Meier curves were used to depict the patient survival from surgery. Results There were 21 cases of primary cardiac paraganglioma, 19 of whom had surgical resection with 3 refusing offered surgery. Of 19 resected tumors, 13 originated from the left atrium and 6 originated from the roots of the pulmonary artery and the aorta. Complex procedures were required, including aortic and pulmonary root replacement and 8 autotransplants. All tumors had complete gross resection with no identifiable disease left behind, but 4 of these had microscopically positive margins. None of the patients had local recurrence of disease. There was 1 case of metastatic paraganglioma with death at 4 years postsurgery. Operative mortality was 10.6%. Survival from surgery was 88.2%, 71.8%, and 71.8% and 1, 5, and 10 years, respectively. Conclusions Cardiac paraganglioma presents a surgical challenge. Mortality and long-term survival after surgical resection are acceptable but may require complex resection and reconstruction. |
| Databáze: | OpenAIRE |
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