Cardiac Tumor
Conditions
Keywords
congenital heart disease, cardiac tumor, surgical technique
Brief summary
This study was a retrospective descriptive case series analyzing outcomes of a novel surgical approach This study aimed to evaluate a modified surgical technique-called the Sandwich Procedure-for reconstructing the heart after resection of cardiac fibromas in children. Cardiac fibroma is a rare benign tumor that can compress vital cardiac structures and cause serious symptoms such as arrhythmia, heart failure, or obstruction of blood flow. Surgical removal is often required, but large tumors may leave defects in the heart wall that are challenging to repair, especially in young children. The Sandwich Procedure was developed at our institution to improve the strength and stability of heart wall reconstruction after tumor removal. It involves suturing two layers of treated biological tissue-both inside and outside the heart wall-to restore normal shape and function, while minimizing the risk of complications like aneurysm or bleeding. This retrospective, observational study includes pediatric patients who underwent this procedure between 2018 and 2023. We report on its surgical feasibility, short- and mid-term outcomes, and potential benefits in preserving cardiac function.
Interventions
PROCEDUREventricular reconstruction
The Sandwich Procedure was developed at our institution to improve the strength and stability of heart wall reconstruction after tumor removal. It involves suturing two layers of treated biological tissue-both inside and outside the heart wall-to restore normal shape and function, while minimizing the risk of complications like aneurysm or bleeding.
Sponsors
China National Center for Cardiovascular Diseases
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
No minimum to 14 Years
Healthy volunteers
No
Inclusion criteria
* underwent cardiac tumor resection * underwent ventricular reconstruction with the Sandwich Procedure
Exclusion criteria
* the final pathological diagnosis indicated other than cardiac fibroma * the final pathological diagnosis indicated metastatic tumors * incomplete clinical or follow-up data
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| composite endpoint | up to 5 years | all-cause mortality or cardiac reoperation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ventricular failure | up to 5 years | left ventricular ejection fraction (LVEF) \< 55% or right ventricular fractional area change (RVFAC) \< 45% by echocardiography |
| ventricular aneurysm | up to 5 years | newly formed segmental dyskinesia with localized dilation |
| malignant arrhythmia | up to 5 years | sustained ventricular tachycardia, ventricular fibrillation, or frequent polymorphic premature ventricular contractions requiring medical intervention |
| Heart block | up to 5 years | any new onset of high-degree atrioventricular block (Mobitz II or complete AVB), as well as complete left bundle branch block (CLBBB) by ECG |
| severe perioperative complications | before discharge | including low cardiac output syndrome \[cardiac index \< 2.0 L/(min·m2)\], delayed sternal closure, prolonged invasive mechanical ventilation (≥ 7 days) and need for extra-corporeal membrane oxygenation (ECMO) |
Countries
China
Outcome results
None listed