Successful Surgical Management of Cardiac Fibroma with Recurrent Ventricular Tachycardia: A Case Report PD03-PD05
Dr. Avishek Samaddar,
House Number 822, Sector 16d, Chandigarh-160015, India.
Cardiac fibromas are rare tumours of the heart. We present a case of cardiac fibroma in a four-year-old child in view of rarity of the case and success achieved in its management. The child had presented with a history of intermittent palpitations. Electrocardiography (ECG) showed monomorphic Ventricular Tachycardia (VT). She was initially managed with intravenous Metoprolol and Amiodarone infusion but had recurrent VT. Echocardiography revealed a mass in the apical septum. A Contrast Enhanced Computed Tomography (CECT) showed a homogeneous mass involving the anterolateral and apical aspect of interventicular septum causing expansion of the septum and indentation and compression of both ventricles. The tumour was approached through median sternotomy under Cardiopulmonary Bypass (CPB). The adventitia over the exposed part of the tumour was incised and the tumour was dissected out of the interventricular septum. A bovine pericardial patch was used to close the septal defect. Most of the small tumours dispersed around Left Anterior Descending Artery (LAD) were excised. The patient was weaned off CPB easily. In the postoperative period, Amiodarone infusion was continued with no recurrence of arrhythmias. Histopathology revealed classical features of fibroma. The child is stable and is on outpatient follow-up. Our patient had a huge fibroma and we could successfully resect it avoiding need for transplant. We hereby conclude that in children with a huge intracardiac fibroma involving almost a complete cardiac chamber, success can be achieved through resection and reconstruction in selected cases and the need for transplant may be obviated.