Agarwal Vijay, Agarwal Surendra Kumar, Srivastava Ashok Kumar, Kapoor Shalini
Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
Indian Heart J. 2003 Nov-Dec;55(6):632-6.
Primary cardiac tumors are rare. There are only a few reports of such tumors from India.
We report our experience with 34 patients with primary cardiac tumors operated on at our institute between December 1989 and October 2001. The study group comprised 16 males and 18 females with a mean age of 40.05 +/- 13.06 years (range 7-65 years). The predominant symptoms were breathlessness and congestive heart failure. In addition, 1 patient presented with peripheral embolism with impending limb ischemia that necessitated emergency embolectomy. Echocardiography was confirmatory in the diagnosis of all the benign tumors, whereas the malignant tumors were incidentally found during surgery. All the patients survived the operation. Complete resection of the tumor was possible only in benign tumors; however, malignant tumors were partly removed to relieve obstruction. All the excised benign tumors showed no recurrence on a mean follow-up of 54.78 +/- 31.30 months (range 3-108 months). Myxoma was found in 31 patients, left ventricular fibroma in 1, and leiomyosarcoma in 2. Both the patients with malignant tumors developed recurrence postoperatively, and succumbed to extensive distant metastases.
The long-term outcome of surgery was excellent in patients with benign cardiac tumors. However, malignant tumors had an unchanged prognosis, although symptomatic relief was achieved.
原发性心脏肿瘤较为罕见。来自印度的此类肿瘤报告仅有少数几例。
我们报告了1989年12月至2001年10月间在我院接受手术的34例原发性心脏肿瘤患者的情况。研究组包括16名男性和18名女性,平均年龄为40.05±13.06岁(范围7 - 65岁)。主要症状为呼吸困难和充血性心力衰竭。此外,1例患者出现外周栓塞并伴有即将发生的肢体缺血,需要紧急进行栓子切除术。超声心动图对所有良性肿瘤的诊断具有确诊作用,而恶性肿瘤则在手术中偶然发现。所有患者均存活至手术结束。仅良性肿瘤可行肿瘤完整切除;然而,恶性肿瘤则部分切除以缓解梗阻。所有切除的良性肿瘤在平均54.78±31.30个月(范围3 - 108个月)的随访中均未复发。31例患者为黏液瘤,1例为左心室纤维瘤,2例为平滑肌肉瘤。两名恶性肿瘤患者术后均复发,并死于广泛的远处转移。
良性心脏肿瘤患者手术的长期效果极佳。然而,尽管恶性肿瘤实现了症状缓解,但其预后并无改善。