Research & Innovation | Overview
Given their rarity, there is limited research on heart tumors, but over the years, the Benderson Family Heart Center team has made clinical research a priority. Their focus has been in three primary areas.
Heart tumor diagnostics
The team has developed methodology to identify tumor type by MRI in conjunction with echocardiography.
- Kiaffas MG, Powell AJ, Geva T. Magnetic resonance imaging evaluation of cardiac tumor characteristics in infants and children. Am J Cardiol 2002;89:1229-1233.
- Mackie AS, Kozakewich HPW, Geva T, Perez-Atayde AR, Mulliken JB. Vascular tumors of the heart in infants and children: Case series and review of the literature. Ped Cardiol 2005;26:344-349.
- Beroukhim RS, Prakash A, Valsangiacomo Buechel ER, Cava JR, Dorfman AL, Festa P, Hlavacek AM, Johnson TR, Keller MS, Krishnamurthy R, Misra N, Moniotte S, Parks J, Powell AJ, Soriano BD, Srichai MB, Yoo SJ, Zhou J, Geva T. Characterization of cardiac tumors in children by cardiovascular magnetic resonance imaging: a multicenter experience. J Am Coll Cardiol 2011;58:1044-1054.
- Beroukhim RS, Geva T. Primary and secondary cardiac tumors. In: da Cruz EM, Ivy D, and Juggers J (eds.). Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care. London: Springer-Verlag 2014;2275-2295
Tumor-associated arrhythmias
Potentially life-threatening arrhythmias often complicate cardiac tumors. Our team has extensive experience with management of atrial and ventricular arrhythmias in these patients and has published on treatment strategies in patients with rhabdomyomas and fibromas.
- Miyake CY, del Nido PJ, Alexander ME, Cecchin F, Berul CI, Triedman JK, Geva T, Walsh EP. Cardiac Tumors and Associated Arrhythmias in Pediatric Patients, With Observations on Surgical Therapy for Ventricular Tachycardia J Am Coll Cardiol 2011;58:1903-1909
- Chrystalle Katte Carreon, Stephen P. Sanders, Antonio R. Perez-Atayde, Pedro J. del Nido, Edward P. Walsh, Tal Geva, Mark E. Alexander. Interdigitating Myocardial Tongues in Pediatric Cardiac Fibromas: Plausible Substrate for Ventricular Tachycardia and Cardiac Arrest. JACC Clin Electrophysiol. 2019 May;5(5):563-575.
Surgical management and techniques
Surgery is the most comprehensive and contemporary approach in carefully selected patients with pediatric cardiac tumors. However, the management strategy and, in particular, the surgical approach for ventricular fibromas can pose a challenge. The large tumor size in relationship to the ventricular chambers and encroachment on vital adjacent structures has often been considered a limiting factor.
The heart tumor team has safely managed large ventricular fibromas with total or near total excision, removing the risk of life-threatening arrhythmias with excellent clinical results. We have not recommended heart transplant in children we have treated for fibroma.
- Nathan M, Fabozzo A, Geva T, Walsh E, del Nido JP. Successful surgical management of ventricular fibromas in children J Thorac Cardiovasc Surg 2014;148:2602-8