Long-Term Follow-Up after Partial Left Ventricular Wall Replacement Due to Cardiac Tumor in Childhood
In 1979 an 8-year-old girl presented with malignant ventricular arrhythmias. Her history was uneventful except for slight atypical cardiomegaly on chest X-ray. Without benefit of echocardiography at that time, the assumption of a paracardiac tumor was made. Angiography of the heart revealed a flat im-pression of the right ventricle as well as a tumorous mass extending to the pos-terolateral wall. Urgent operation showed an intramural tumor of the left ven-tricular wall, 10 × 6 × 6 cm in size and consuming nearly the total area between the first diagonal branch of the LAD and the first marginal branch of the circumflex artery. Resection of the tumor left such an extensive defect that direct suturing was impossible. To preserve ventricular geometry the defect was closed by a 7 × 4 cm oval Dacron patch implanted in sandwich technique. Histological examination revealed a fibroma. At follow-up 8 years after the operation we found uneventful development and inconspicuous, active life-history; normal ECG at rest and exercise (125 W); and normal values for right and left ventricular and aortic root dimensions, diastolic wall thicknesses, systolic wall thickening, as well as valve excursions on the basis of echocardiography. This case report demonstrates that operability of ventricular cardiac tumor in childhood should only be evaluated by the expected functional outcome immediately after operation. With growth of the heart the relative amount of the ventricular wall defect decreases and even extreme akinetic segments will be compensated functionally.
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