Bakkali A, Sedrati M, Cheikhaoui Y, Kacemi R D, Maazouzi W
Service de chirurgie cardiovasculaire A, hôpital Ibn-Sina, Rabat, Maroc.
Ann Cardiol Angeiol (Paris). 2009 Apr;58(2):94-8. doi: 10.1016/j.ancard.2008.07.013. Epub 2008 Aug 22.
This study aims to report clinical particularities, treatment concepts, potential evolution related to cardiac myxoma to the light of our initial experience and reviewed of the literature.
Between May 1980 and January 2005: 23 patients were operated in our service for cardiac myxoma. There were 21 left-atrium myxomas and two in right atrium. The mean age was 42.73 years (range 21 to 60 years). The sex-ratio was 2.28 (16 women and seven men). In four cases, the myxomas were chance findings at echocardiography but the 19 symptomatic patients had different symptoms: dyspnea, palpitations, left ventricular failure, positional syncope, systemic embolism, chest pain or right ventricular failure. The diagnostic of myxoma was realized in all cases by echocardiography. The resection of the tumor and a wide part of the inter-atrial septum were performed in all case. The post-operative course was usually uncomplicated: only one patient had double recurrence and died of mediastinitis after the third operation.
The myxoma is considered to be rare, and remains classical emergency with low operative risk, however the risk of recurrence imposes a long-term follow-up by echocardiography.
本研究旨在根据我们的初步经验并结合文献复习,报告心脏黏液瘤的临床特点、治疗理念及潜在演变情况。
1980年5月至2005年1月期间,我们科室为23例心脏黏液瘤患者实施了手术。其中左心房黏液瘤21例,右心房黏液瘤2例。平均年龄42.73岁(范围21至60岁)。男女比例为2.28(16例女性,7例男性)。4例黏液瘤是在超声心动图检查时偶然发现的,而19例有症状的患者有不同症状:呼吸困难、心悸、左心室衰竭、体位性晕厥、全身栓塞、胸痛或右心室衰竭。所有病例均通过超声心动图确诊黏液瘤。所有病例均进行了肿瘤切除及广泛的房间隔部分切除。术后病程通常无并发症:仅1例患者复发两次,第三次手术后死于纵隔炎。
黏液瘤虽被认为罕见,仍是典型的低手术风险急症,但复发风险要求通过超声心动图进行长期随访。