Issues of diagnosis, surgical treatment tactics and postoperative management of patients with malignant cardiac tumors.

The incidence of cardiac tumors (CT) is 0.5 cases per 1 million population, and 10% of them are malignant cardiac tumors (MCT). The in-hospital mortality rate of patients with MCT is 20–50%. The aim of the study: to determine the optimal diagnostic and surgical tactics for malignant cardiac tumors based on many years of single-center experience, taking into account the radicality of tumor removal, the need for reconstruction of affected cardiac structures, and the prevention of intraoperative and early postoperative complications. Materials and methods. In the M.M. Amosov National Scientific Center of Cardiovascular Surgery and Hereditary Pathology of the NAMS of Ukraine for the period from 01.01.1969 to 01.01.2026, 1061 patients with CT operated on. Non-myxomatous benign CT observed in 42 (4.1%) cases. МCT were observed in 71 (6.7%) cases. The age of patients with СT ranged from 3 to 80 years (average 49.4±3.4 years), among patients with МCT there were 36 women (50.8%). Results. Of the 71 case­s 61 (85.9%) operations were performed using artificial blood circulation, of which 24 (33.8%) were conditionally radical cardiac surgical interventions with a good hemodynamic effect. To achieve the most radical removal of the neoplasm in 31 (43.7%) cases, additional surgical manipulations used, including plastic surgery of the interatrial septum, atrial walls, plastic correction of valve damage, and prosthetics of heart valves. Hospital mortality during surgical treatment МCT was 18.3% (13 patients). A scheme of detoxification measures was developed and applied at the operative and early postoperative stages, thanks to the use of which it was possible to reduce hospital mortality from 33.3% (1970–2003) to 4.8% over the last 20 years (2004–2025). Conclusions. Diagnosis of МCT is complicated by the polymorphism of the nature of the course and localization of МCT, which in most cases leads to late detection and admission of these patients to cardiac surgery centers. In the surgical treatment of МCT, to achieve maximum hemodynamic effect, it is very often (43.7%) necessary to use advanced methods of reconstruction of damaged heart structures, as well as conducting detoxification preventive measures both in the intraoperative and early postoperative period in this cohort of patients, which reduces mortality from 33.3% to 4.8%. The duration of survival of patients after removal of МCT is ensured by urgent adequate chemotherapy in the early postoperative period, which will not allow metastases to activate, which are most often the cause of death of these patients after surgical treatment.