This article has Open Peer Review reports available.
Surgical treatment of left ventricular fibroma accompanied with ventricular septal defect in an infant: a case report
- Yibo Gong1,
- Ni Yin1 and
- Jinfu Yang1Email author
https://doi.org/10.1186/1749-8090-9-37
© Gong et al.; licensee BioMed Central Ltd. 2014
Received: 4 October 2013
Accepted: 17 February 2014
Published: 20 February 2014
Abstract
Primary cardiac tumor in infancy is an uncommon condition which is rarely accompanied with congenital heart disease. Although these tumors are generally benign, the complication associated with it, such as arrhythmia, outflow tract obstruction, and heart failure, may result in early mortality, when combined with congenital heart disease. Early surgical treatment may reduce complication risk and increase operative success rate which may improve the patient’s long-term prognosis. Herein, we report a case of an eight-month-old Chinese baby boy diagnosed with a calcified fibroma combined with ventricular septal defect, the tumor excision and repair of ventricular septal defect were done at the same time.
Keywords
Background
Primary cardiac tumors in infancy and childhood are uncommon, and approximately 70% of them are benign with morbidity rate of around 0.27% to 0.8%. Most specialists advocate early individualized surgical resection to reduce mortality caused by complications such as heart inflow/outflow tract obstruction, and malignant arrhythmia. Up to now, cardiac fibroma accompanied with VSD and PH has never been reported before, let alone simultaneous surgical treatment of both conditions.
Case presentation
Surgical exploration reveals a firm 4 cm × 3.5 cm × 3 cm mass with unclear-edge under the LCX (1) and LAD (2). The cardiac mass, which was supplied by a large branch from LCX was surgically removed. 4 panels (a,b,c,d) show the whole process how the mass removed from LV.
Pathological examinations of the removed mass report revealing calcifying fibroma (Armed by the arrow). 4 panels (a,b,c,d) show tumor tissue under microscope in different multiples and different position. The graphs which show normal tissue around the tumor also prompts the tumor has been completely resected.
Discussion
Primary cardiac tumors in infancy and childhood are uncommon, and approximately 70% of them are benign with morbidity rate of around 0.27% to 0.8%[1]. Cardiac fibromas, which normally arise from heart fibroblasts or myofibroblast, accounts for around 2% to 5% of all benign tumors in the heart[2]. Because of the complications such as heart inflow/outflow tract obstruction, and malignant arrhythmia associated prognosis of cardiac fibromas, many specialists advocate early individualized surgical resection[3–5]. Up to now, cardiac fibroma accompanied with VSD and PH has never been reported before, let alone simultaneous surgical treatment of both conditions. Left ventricular tumor excision combined with heart malformation correction is more complex than simple tumor excision because of prolonged CPB time, greater operation trauma.
Conclusion
Early tumor resection is recommended in such case to guarantee a successful surgical outcome with less potential complications. Secondly our experience showed that a combined surgical procedure to excise a cardiac tumor and repair a congenital heart defect is feasible and safe.
Consent
Written informed consent was obtained from the patient’s parents for publication of this Case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
Abbreviations
- CHD:
-
Congenital heart disease
- VSD:
-
Ventricular septal defect
- CPB:
-
Cardiopulmonary bypass
- LAD:
-
Left anterior descending
- LCX:
-
The left circumflex
- PH:
-
Pulmonary hypertension.
Declarations
Acknowledgements
We greatly appreciate the assistance of Muhoozi Rwakaryebe MD.
Authors’ Affiliations
References
- Allen HD, Driscoll DJ, Shaddy RE, Feltes TF: Moss and Adams' heart disease in infants, children, and adolescents: Including the fetus and young adult. Edited by: FR DS. 2007, Philadelphia: Lippincott Williams & Wilkins, 7Google Scholar
- Burke A, Jeudy J, Virmani R: Cardiac tumours: an update. Heart. 2008, 94 (1): 117-123. 10.1136/hrt.2005.078576.View ArticlePubMedGoogle Scholar
- Horovitz A, van Geldorp IE, Roubertie F, Thambo J-B: Large right ventricular fibroma in a 6-month-old infant. Pediatr Cardiol. 2012, 1-3.Google Scholar
- Elahi M, Poh C-L, Krishna A, Grant P: Surgical considerations for large asymptomatic cardiac fibromas in the context of fatal ventricular arrhythmias. Heart, Lung and Circulation. 2012, 21 (11): 750-753. 10.1016/j.hlc.2012.03.005.View ArticlePubMedGoogle Scholar
- Torimitsu S, Nemoto T, Wakayama M, Okubo Y, Yokose T, Kitahara K: Literature survey on epidemiology and pathology of cardiac fibroma. Eur J Med Res. 2012, 17 (1): 5-10.1186/2047-783X-17-5.View ArticlePubMedPubMed CentralGoogle Scholar
Copyright
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
