Bortolotti U, Maraglino G, Rubino M, Santini F, Mazzucco A, Milano A, Fasoli G, Livi U, Thiene G, Gallucci V
Department of Cardiovascular Surgery, University of Padova Medical School, Italy.
Ann Thorac Surg. 1990 Mar;49(3):449-53. doi: 10.1016/0003-4975(90)90253-3.
Since November 1968, 54 patients have undergone excision of an intracardiac myxoma, which was located in the left atrium in 46 (85%), in the right atrium in 6 (11%), and in the right ventricle in 2 (4%). There were 35 female and 19 male patients with a mean age of 48 +/- 14 years (range, 7 to 68 years). Four patients were asymptomatic; the others were seen mostly with exertional dyspnea, palpitation, signs of systemic illness, and syncopal episodes. Before operation, embolic episodes occurred in 13 patients with a left atrial myxoma. There were two early (3.7%) and two late deaths (3.8). Actuarial survival at 20 years is 91% +/- 4%, and most of the current survivors are asymptomatic at a mean follow-up of 6.5 +/- 5 years (range, 0.2 year to 20 years). Noninvasive reevaluation was performed with echocardiographic studies in 44 patients and 24-hour electrocardiographic monitoring in 34. No instances of tumor recurrence were observed, and there was a low incidence of major supraventricular arrhythmias late postoperatively. We conclude that excision of intracardiac myxomas is curative and long-term survival is excellent. The transseptal approach provides adequate exposure and allows complete removal of the tumor regardless of its location.
自1968年11月以来，54例患者接受了心内黏液瘤切除术，其中46例（85%）位于左心房，6例（11%）位于右心房，2例（4%）位于右心室。有35例女性和19例男性患者，平均年龄为48±14岁（范围为7至68岁）。4例患者无症状；其他患者主要表现为劳力性呼吸困难、心悸、全身疾病体征和晕厥发作。术前，13例左心房黏液瘤患者发生栓塞事件。有2例早期死亡（3.7%）和2例晚期死亡（3.8%）。20年的实际生存率为91%±4%，目前大多数幸存者在平均6.5±5年（范围为0.2年至20年）的随访中无症状。44例患者通过超声心动图检查进行无创复查，34例患者进行24小时心电图监测。未观察到肿瘤复发情况，术后晚期主要室上性心律失常的发生率较低。我们得出结论，心内黏液瘤切除术具有治愈性，长期生存率良好。经房间隔入路可提供充分暴露，无论肿瘤位于何处，均可将其完整切除。
