Thorac cardiovasc Surg 2019; 67(08): 659-664
DOI: 10.1055/s-0038-1667319
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Surgical Treatment of Cardiac Metastases: Analysis of a 13-Year Single-Center Experience

Sabreen Mkalaluh
1  Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany
,
Marcin Szczechowicz
1  Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany
,
Saeed Torabi
1  Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany
,
Anton Sabashnikov
2  Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany
,
Ahmed Mashhour
3  Department of Cardiac Surgery, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
,
Matthias Karck
1  Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany
,
Alexander Weymann
1  Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany
› Author Affiliations
Further Information

Publication History

01 April 2018

21 June 2018

Publication Date:
09 August 2018 (online)

Abstract

Background Cardiac metastases are more common than primary malignant tumors of the heart and are usually treated surgically as a palliative approach. In this study, we reviewed our experience with the surgical treatment of patients with cardiac metastases of various types of malignant tumors.

Methods Between 2003 and 2016, 10 patients underwent surgery for cardiac metastases at our institution.

Results The mean age was 53.5 ± 19 years. Female patients made up 60% (n = 6) of the collective. The cohort included cardiac metastases of diverse origins (peripheral sarcomas, melanoma, rectal carcinoma, and hepatocellular carcinoma). The left side of the heart was more frequently affected (n = 7). In only six patients, the primary malignancy was known at the time of cardiac surgery. The interval between the first diagnosis of the primary tumor and cardiac metastases ranged from simultaneous diagnosis to up to 19 years. At the time of the diagnosis of the cardiac metastases, seven patients already had multiple metastases: all seven patients had pulmonary metastases, and three of them additionally had hepatic, cerebral, or osseous metastases. Only four patients were symptomatic (atrial fibrillation, pericardial effusion, tachycardia with chest pain, dyspnea). There was no in-hospital death. The postoperative course was uneventful overall. The one- and two-year survival rates were similar, that is, 76%. The median follow-up time was 5.4 years.

Conclusions Surgical intervention for treating cardiac metastases is associated with uneventful clinical outcome and acceptable survival in this critically ill population. Control of the primary malignancy, and maybe other metastases, determines the survival.