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.
Keywords
cardiac metastases - surgery - palliative therapy
