Kucukarslan Nezihi, Kirilmaz Ata, Ulusoy Eralp, Baysan Oben, Yildirim Vedat, Ozal Ertugrul, Sahin Mehmet A, Tatar Harun
Gata Military Medical Faculty, Department of Cardiovascular Surgery, Etlik, Ankara, Turkey.
J Card Surg. 2007 Jan-Feb;22(1):39-42. doi: 10.1111/j.1540-8191.2007.00335.x.
Tumors arising from the right atrium are quite rare, and require special care during differential diagnosis for their management. A review of surgical experience with right atrial tumors in 11 patients from our institution has been presented in this article.
Eleven cases, operated for a tumor mass in the right atrium in our institution between January 1993 and December 2004, were retrospectively reviewed for their clinical presentation, diagnostic workup, method of surgical procedure, and histopathologic findings. Electrocardiogram, transthoracic, and transesophageal echocardiography, computerized tomography, and nuclear magnetic resonance imaging were available for all patients during the diagnostic evaluation. Surgical procedure notes, photos, and file recordings were reviewed when available. The surgeons were also interviewed when necessary.
Right atrial tumors were diagnosed in 11 patients (6 males and 5 females). The average age of the patients was 34 +/- 11 years (ranging between 21 and 65 years). The histopathological examination of the surgically removed specimen revealed a benign tumor in eight patients (73%), and a malignant process in three (23%). In eight patients with a benign tumor, atrial myxoma was the leading cause in half of the cases. Hydatid cyst (n = 2), lipoma (n = 1), and right atrial thrombus (n = 1) were detected in the remaining four patients. One patient died of heart failure after surgery. The diameters of the excised masses were 2 +/- 0.5 cm versus 7 +/- 1 cm.
Tumors of the right atrium are rarely seen, and necessitate a unique attention during the process of diagnosis and surgical treatment. We present our surgical experience of 11 patients with right atrial mass. The differentiation of the right atrial tumors with the diagnostic tools before surgery, the determination of the spreading, and the structural properties of the mass may designate surgical approach and prognosis.
起源于右心房的肿瘤非常罕见，在鉴别诊断及治疗过程中需要特别关注。本文回顾了我院11例右心房肿瘤患者的手术经验。
回顾性分析1993年1月至2004年12月间在我院因右心房肿物接受手术的11例患者的临床表现、诊断检查、手术方法及组织病理学结果。所有患者在诊断评估期间均进行了心电图、经胸及经食管超声心动图、计算机断层扫描和核磁共振成像检查。如有手术记录、照片及病历资料，均进行回顾分析。必要时还对手术医生进行了访谈。
11例患者（6例男性，5例女性）被诊断为右心房肿瘤。患者平均年龄为34±11岁（21至65岁）。手术切除标本的组织病理学检查显示，8例患者（73%）为良性肿瘤，3例患者（23%）为恶性病变。在8例良性肿瘤患者中，半数病例的主要病因是心房黏液瘤。其余4例患者中，发现包虫囊肿（n = 2）、脂肪瘤（n = 1）和右心房血栓（n = 1）。1例患者术后死于心力衰竭。切除肿物的直径分别为2±0.5 cm和7±1 cm。
右心房肿瘤少见，在诊断和手术治疗过程中需要特别关注。我们介绍了11例右心房肿物患者的手术经验。术前通过诊断工具鉴别右心房肿瘤、确定肿物的扩散情况及其结构特性，可能有助于确定手术方式及判断预后。
