D'Alfonso Alessandro, Catania Salvatore, Pierri Michele D, Matteucci Sacha Lm, Rescigno Giuseppe, Münch Christopher, Staine Josephine, Iacobone Gianfranco, Piccoli Gian Piero
Division of Cardiac Surgery, Presidio Lancisi, Ospedali Riuniti, Ancona, Italy.
J Cardiovasc Med (Hagerstown). 2008 Feb;9(2):178-81. doi: 10.2459/JCM.0b013e3281ac22cb.
A single-institutional study on atrial myxoma. Patient data and data obtained from the survivors during follow-up were reviewed.
We studied 109 patients (61.5% female) who underwent surgical excision of atrial myxoma between January 1980 and December 2005. Mean age at the time of surgery was 60 +/- 14 years (range 1-83 years). Overall survival and atrial myxoma recurrence were determined by Kaplan-Meier analysis. Linearized rates of recurrence at follow-up are reported.
One hundred and two (93.6%) of the 109 tumours were found in the left atrium. Comparative mean age distribution revealed a significant difference between patients operated on between 1980 and 1992 and patients operated on between 1993 and 2005 (55 +/- 15 and 63 +/- 13 years, respectively; P < 0.05). All patients survived the operation. Three patients were lost to follow-up. The 15-year and 25-year survival rates were 91 +/- 4% and 72 +/- 12%, respectively. Survival of patients after myxoma removal did not significantly differ from the expected survival of the general population. Recurrent myxomas developed in two patients (mean age 50 +/- 7 years) with a 25-year freedom from reoperation of 96 +/- 3% and a linearized rate of 0.17 +/- 0.12%/year.
Myxomas tend to be observed in a more elderly and higher-risk population, often at an early stage. The extended follow-up of patients with intracardiac myxomas shows that surgical excision of such tumours is curative with low mortality and good long-term outcome.
一项关于心房黏液瘤的单机构研究。回顾了患者数据以及随访期间幸存者的数据。
我们研究了1980年1月至2005年12月期间接受心房黏液瘤手术切除的109例患者(女性占61.5%)。手术时的平均年龄为60±14岁(范围1 - 83岁)。通过Kaplan-Meier分析确定总生存率和心房黏液瘤复发率。报告随访时的线性复发率。
109个肿瘤中有102个(93.6%)位于左心房。比较平均年龄分布显示,1980年至1992年接受手术的患者与1993年至2005年接受手术的患者之间存在显著差异(分别为55±15岁和63±13岁;P<0.05)。所有患者均手术存活。3例患者失访。15年和25年生存率分别为91±4%和72±12%。黏液瘤切除术后患者的生存率与一般人群的预期生存率无显著差异。两名患者(平均年龄50±7岁)出现复发性黏液瘤,25年无再次手术的自由度为96±3%,线性化率为0.17±0.12%/年。
黏液瘤往往在年龄较大、风险较高的人群中更易观察到,且通常处于早期阶段。对心脏黏液瘤患者的长期随访表明,手术切除此类肿瘤具有治愈性,死亡率低且长期预后良好。