Surgical outcomes of cardiac fibroma in children: Early results.

Objective: To describe our surgical techniques and early outcomes after resection of cardiac fibromas in symptomatic children. Methods: A retrospective analysis was performed including all patients who underwent surgical resection of cardiac fibroma at a single institution between May 2021 and April 2024. Parameters reviewed were age, weight, genetic predisposition, clinical presentations, and results of investigations, including 3-dimensional virtual reality imaging. Completeness of resection, intraoperative complications, immediate postoperative outcomes and follow-up parameters including redo operations, arrhythmias, and mortality were analyzed. Results: The median age at surgery was 12 months (interquartile range [IQR], 8-129 months), and the median weight was 8.7 kg (IQR, 7.5-48.1 kg). The most common clinical presentation was ventricular arrhythmia (n = 5), and the left ventricular chamber was involved in all cases. Transmural resection was done in 5 cases, and complete resection was possible in 3. The cavity after resection was obliterated by layered closure using polypropylene. Loop recorders were implanted simultaneously in 4 cases. All patients had normal sinus rhythm at discharge, and the mean left ventricular ejection fraction was 55 ± 7%. The median duration of follow-up was 12 months (IQR, 11-32 months). One patient had recurrent arrhythmia and underwent reoperation owing to growth of the residual tumor. One patient with incomplete resection required implantation of an implantable cardioverter-defibrillator at 30 months after surgery. All patients were on anti-arrhythmic drugs and had a normal ECG on loop recorder analysis. Conclusions: Complete resection of cardiac fibroma is preferred but can be limited by tumor location. Arrhythmia-free survival can be achieved in most cases.