BRIEF COMMENTS
EXPERT: Prof. Henryk Siniawski MD, PhD, cardiac surgeon
Affiliation: German Heart Instiute, Berlin, Germany
COMMENT
Due to its fibrotic character total removal of the pathological tissue is impossible. I would recommend close follow-up with regular check-up every 3 months. Should the patient become symptomatic partial resection of the tumor may be necessary.
EXPERT: Prof. Bogusław Kapelak MD, PhD, cardiac surgeon
Affiliation: Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow, Poland
COMMENT
It is not feasible to perform total resection of the septal tumor. In case of symptoms one must consider partial excision.
EXPERT: Prof. Piotr Podolec MD, PhD, cardiologist
Affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow, Poland
COMMENT
Could transplantation of intraventricular septum be an option?
EXPERT: Prof. Henryk Siniawski MD, PhD, cardiac surgeon
Affiliation: German Heart Instiute, Berlin, Germany
COMMENT
Although the idea is an interesting one, maintaining continuity of His and Purkinije fibers would make it very difficult to achieve using medical technology of today.
EXPERT: Prof. Egle Ereminiene MD, PhD, cardiologist
Affiliation: Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
COMMENT
The patient remains asymptomatic. I would recommend performing a stress test (e.g. stress echocardiogram) to assess her physical capacity. The patient should be aware of possible surgical treatment in the future. All therapeutic decisions and possible complications must be discussed with the patient with regard to her lfe plans (e.g. pregnancy, career).
EXPERT: Prof. Lesław Szydłowski, MD, PhD, pediatric cardiologist
Affiliation: 1st Department of Pediatric Cardiology, Medical University of Silesia, Katowice-Ligota, Poland
COMMENT
The patient is currently in good general state and asymptomatic. Even partial resection of a heart muscle may impair its function. I would recommend close follow-up and another CRCD consultation in 1 or 2 years from now.
EXPERT: Prof. Piotr Podolec MD, PhD, cardiologist
Affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow, Poland
COMMENT
It is not unlikely we will be able to offer the patient some new therapeutic options in the near future.
EXPERT: Prof. Zbigniew Gąsior, MD, PhD, cardiologist
Affiliation: 2nd Department of Cardiology, Medical University of Silesia, Katowice, Poland
COMMENT
I share Professor Szydłowski’s view. I would also consider performing functional tests (stress echocardiogram or cardiopulmonary exercise test for instance) – the tumor might generate syncope of arrhythmias. If results of those tests are negative, close follow-up is advisable.
EXPERT: Prof. Henryk Siniawski MD, PhD, cardiac surgeon
Affiliation: German Heart Instiute, Berlin, Germany
COMMENT
Considering the tumor’s current size, location and its fibrotic character LVOT blood flow obstruction is improbable. However, echocardiographic stress test and CPX could provide us with relevant information. Close follow-up is strongly recommended.
CONCLUSIONS
1. Conservative treatment and close follow-up is recommended at present.
2. Echocardiographic stress test and/or cardiopulmonary exercise test should be performed in order to assess the patient’s physical capacity.
3. If the patient becomes symptomatic, partial tumor resection should be considered.
4. All available therapeutic options must be discussed with the patient in detail.
“Development of the European Network in Orphan Cardiovascular Diseases”
“Rozszerzenie Europejskiej Sieci Współpracy ds. Sierocych Chorób Kardiologicznych”
