Surgical Treatment of Primary Cardiac Tumors in Children Systematic Review and Meta-analysis

Demographic and Clinical Characteristics of Children with Primary Cardiac Tumors Hospitalized from 1997 to 2019 in the United States

Cardiac tumors in children, although rare, can lead to obstruction of valves or cardiac conduction problems. Large multi-site or national data on pediatric cardiac tumors is lacking. The objective of this study was to determine the prevalence of primary cardiac tumors in hospitalized children from 1997 to 2019 in the US and analyze the demographic and clinical characteristics of children with cardiac tumors. We conducted a cross-sectional analysis using the Healthcare Cost and Utilization Project's Kid's Inpatient Database from 1997 to 2019. Children with cardiac tumors were identified using ICD-9 and ICD-10 diagnosis codes. The prevalence is presented per 100,000 hospital discharges and 1,000,000 age-specific US population. The Chi-square test was used to compare the discharges with and without cardiac tumors for demographic and clinical variables. The Chi-square for linear trend (Extended Mantel-Haenszel) test was used for trend analyses. There were 3,166 discharges with primary cardiac tumors out of a total of 55.1 million discharges with a hospitalization rate of 5.8 per 100,000 discharges and 4.82 per million US children. Out of all children with cardiac tumors, 29.9% were neonates, 20.7% were infants, and 71% were children less than 5 years of age. Males comprised 52.9% of all cases. An increase in the prevalence of cardiac tumors from 1997 to 2019 was observed (p < 0.001). Of all admissions with cardiac tumors, 88.9% were reported benign, and 37.3% were admitted to Children's Hospitals. Cardiac arrhythmias were reported in 19.2%, seizures in 28%, and stroke in 1.4%. 51.9% of cases were associated with tuberous sclerosis. Cardiac surgical procedures were performed in 13.9% of patients. The overall hospital mortality rate was 1.6%. Primary cardiac tumor is a rare condition in children and is most common in neonates and young children. Most pediatric cardiac tumors are benign, and many are associated with tuberous sclerosis.

Exploring Cardiovascular Involvement in Tuberous Sclerosis: Insights for Pediatric Clinicians

Tuberous sclerosis is a rare genetic disorder involving mainly the nervous and cardiovascular systems. The early recognition of the cardiovascular manifestations by the pediatrician allows an appropriate management and therefore enhances the quality of life of the affected children. Cardiac rhabdomyomas and the associated arrhythmias are the first cardiac features and they might represent a diagnosis challenge given their wide spectrum of clinical manifestations. We aimed to provide the paediatric practitioners with current knowledge regarding the cardiovascular complications in children with tuberous sclerosis. We overviewed the antenatal and postnatal evolution of cardiovascular manifestations, the systematic screening and long-term follow-up strategy of cardiac rhabdomyomas and arrhythmias in children with tuberous sclerosis.

Current status of diagnosis and treatment of primary benign cardiac tumors in children

Primary cardiac tumors in children are exceedingly rare overall, which benign account for most part. The onset of the disease is occult, while the clinical manifestations are non-specific-patients may be asymptomatic or show a range of obstructive, arrhythmic, embolic or systemic symptoms. The clinical presentations generally depend on the tumors’ size, localization, and pace of growth of the tumor. Moreover, the diagnosis needs comprehensive judgment based on imaging results and pathological examination. With advances in cardiac imagining and the introduction of cardiopulmonary support, the diagnosis and treatment of these rare tumors have improved the prognosis and outlook for benign tumors. To sum up the above, we sought to integrate articles from recent years for the latest comprehensive review of the clinical manifestations, imaging characteristics, clinic pathologic features and treatment of benign cardiac tumors in children to provide a broader idea for pediatricians to recognize and treat such diseases.

Differential diagnosis of cardiac tumors: General consideration and echocardiographic approach

Cardiac tumors may be primary (either benign or malignant) or secondary (malignant) and are first detected by echocardiography in most cases. The cardiologist often challenges their identification, the differential diagnosis and the best therapeutic approach. Malignant tumors have usually a poor prognosis, which may be significantly improved by appropriate and timely therapies. The echocardiographic aspects of benign and malignant cardiac tumors described in this article, along with a clinical evaluation may orient the differential diagnosis and aid in choosing the further steps useful to define the nature of the mass.