左心房心脏肿瘤的发病率及栓塞风险

Morbidity and embolic potential of left atrial cardiac tumors.

作者信息

Dias R R, Stolf N A G, Malbouisson L M, Fernandes F, Ramirez F J A, Mady C, Oliveira S A

机构信息

Heart Institute Incor, University of São Paulo Medical School, São Paulo, Brazil.

出版信息

Thorac Cardiovasc Surg. 2006 Sep;54(6):400-3. doi: 10.1055/s-2006-924091.

DOI:10.1055/s-2006-924091

PMID:16967376

Abstract

BACKGROUND

The aim of the study was to correlate cardiac tumors with implantation site, embolic potential and long-term evolution in patients undergoing surgery.

METHODS

From 1981 to 2004, 78 patients underwent surgery for cardiac tumors. 64 % were female, with a mean age of 44 years. 14 % had embolic episodes (91 % CVA). The sizes of the tumors ranged from 0.4 cm to 10 cm. The most frequent tumors were myxomas (70 %), papillary fibroelastomas and fibromas. The preferential location was the left atrium (72 %). Data were analyzed using chi (2) and Student's T-tests, and the Kaplan-Meyer method and curves were compared with the log-rank test.

RESULTS

Hospital mortality was 6 % and 8.2 % in the follow-up period. Myxoma was predominantly found in the left atrium ( P < 0.0001; OR = 12.8 and 4 - 41 95 % CI). Left atrial tumors showed less mortality ( P = 0.1; OR = 3 and 0.7 - 11.6 95 % CI), with a lower mortality for myxomas ( P < 0.001), fewer recurrences ( P = 0.03; OR = 8.7 and 0.8 - 89 95 % CI), and a greater embolic potential than in other locations ( P = 0.03 % OR = 0.7 and 0.6 - 0.8 95 % CI).

CONCLUSION

Left atrial tumors showed greater embolic potential, fewer recurrences and less mortality.

摘要

背景

本研究旨在探讨接受手术治疗的患者心脏肿瘤与植入部位、栓塞可能性及长期演变之间的关系。

方法

1981年至2004年期间，78例患者接受了心脏肿瘤手术。其中64%为女性，平均年龄44岁。14%的患者发生过栓塞事件（91%为脑血管意外）。肿瘤大小从0.4厘米至10厘米不等。最常见的肿瘤是黏液瘤（70%）、乳头状纤维弹性瘤和纤维瘤。最常见的部位是左心房（72%）。采用卡方检验和学生t检验进行数据分析，并采用Kaplan - Meyer方法，通过对数秩检验比较曲线。

结果

住院死亡率为6%，随访期死亡率为8.2%。黏液瘤主要位于左心房（P < 0.0001；OR = 12.8，95%可信区间为4 - 41.9）。左心房肿瘤死亡率较低（P = 0.1；OR = 3，95%可信区间为0.7 - 11.6），黏液瘤死亡率更低（P < 0.001），复发率更低（P = 0.03；OR = 8.7，95%可信区间为0.8 - 89），且栓塞可能性高于其他部位（P = 0.03；OR = 0.7，95%可信区间为0.6 - 0.8）。