While most primary
tumors of the heart are histologically benign, they are significant space-occupying lesions with serious functional implications for the heart and lungs. Herein, we highlight our experience with the surgical management of selected
cardiac tumors in the pediatric population between 2008 and 2010. (1) Intrapericardial
teratomas in the fetus can produce fatal tamponade from compression by the attendant
pericardial effusion, and a critical life-saving maneuver preoperatively is to drain the effusion prenatally, followed by an expeditious resection after birth. (2)
Rhabdomyomas, the most common of the pediatric
cardiac tumors, can be intracavitary, large, and associated with the mitral subvalvular apparatus. (3) Cardiac
fibromas should be aggressively resected or at least debulked, especially given their propensity for dysrrhythmias. The key to success is as complete a resection as possible, but not at the expense of other normal structures. (4) Complex nonobstructive hypertrophic
myopathy can be thought of as a type of neoplastic overgrowth, and aggressive resection of even midcavitary obstructive lesions should be considered as a viable alternative to primary
transplantation.