Huang Zhixiong, Sun Lizhong, Du Ming, Ruan Yingmao, Wang Hongyue
Department of Cardiovascular Surgery, Cardiovascular Institute, Fu Wai Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
Ann Thorac Surg. 2003 Nov;76(5):1609-13. doi: 10.1016/s0003-4975(03)00961-5.
Our goal was to study the clinical characteristics of primary valve tumors and the late surgical results of their resection.
We reviewed our clinical experience with the surgical treatment of ten primary valve tumors at Fu Wai Hospital over the past 19 years. During that time, cardiac valve tumors accounted for 2.65% of all primary cardiac tumors at our hospital, and the incidence of primary valve tumors was roughly one in 4,000 cardiac operations. There were 5 male and 5 female patients aged 2 to 66 years (mean age, 30.1 years). The clinical presentation included exertional dyspnea in 7 patients, neurological symptoms in 2, and cyanosis at rest in 1 patient. The diagnosis was established by preoperative echocardiography in 8 patients, and in the other 2, it was confirmed by the findings at operation. All of the tumors were resected. Eight of the ten tumors were benign, and two were malignant.
All patients survived the operation and recovered uneventfully. Late outcomes were known for all patients. There were three late deaths. One patient with a benign tricuspid valve tumor died 2 months postoperatively of an electrolyte disorder. The other 2 patients with a malignant mitral valve tumor died within 1 year postoperatively. The 7 survivors, all with a benign valve tumor, were followed for an average of 5.7 years (range, 8 months to 19 years), and all were in functional class I. Exercise tolerance improved to normal levels. The latest follow-up echocardiograms showed no evidence of local recurrence in any patient.
Excellent early and late surgical results can be obtained in patients with benign valve tumors. The prognosis for patients with a malignant valve tumor is poor.
我们的目标是研究原发性瓣膜肿瘤的临床特征及其切除术后的远期手术效果。
我们回顾了过去19年在阜外医院对10例原发性瓣膜肿瘤进行手术治疗的临床经验。在此期间,心脏瓣膜肿瘤占我院所有原发性心脏肿瘤的2.65%,原发性瓣膜肿瘤的发病率约为每4000例心脏手术中有1例。患者共10例,男女各5例,年龄2至66岁(平均年龄30.1岁)。临床表现包括7例劳力性呼吸困难、2例神经症状和1例静息时发绀。8例患者术前经超声心动图确诊,另外2例经手术所见证实。所有肿瘤均被切除。10例肿瘤中8例为良性,2例为恶性。
所有患者术后均存活且恢复顺利。所有患者均有远期随访结果。有3例远期死亡。1例患有良性三尖瓣肿瘤的患者术后2个月死于电解质紊乱。另外2例患有恶性二尖瓣肿瘤的患者术后1年内死亡。7例幸存者均患有良性瓣膜肿瘤,平均随访5.7年(范围8个月至19年),心功能均为I级。运动耐量恢复至正常水平。最新的随访超声心动图显示,所有患者均无局部复发迹象。
良性瓣膜肿瘤患者可获得良好的早期和远期手术效果。恶性瓣膜肿瘤患者的预后较差。