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.