Shirai T, Amano J, Hashizoe M, Sunamori M, Suzuki A, Kataoka N
Nihon Kyobu Geka Gakkai Zasshi. 1989 Dec;37(12):2543-6.
A 72-year-old female underwent successful resection of a giant right atrial myxoma. The patient had slight cough with abnormal cardiac silhouette and elevated ESR. The diagnosis of right atrial myxoma was established by echocardiography and angiography. Venacavography revealed huge mass which occupied in the entire right atrium. This tumor was perfused by well developed feeding arteries arising from both right and circumflex coronary arteries, and showed rich tumor vascularity. This tumor was resected with the interatrial septum and the free wall of the right atrium which were attached with tumor. Interatrial septal defect was closed with a Teflon fabric patch and the defect of right atrial free wall was approximated by direct closure with Z-plasty. Postoperative course was uneventful. Pathological examination showed myxoma without invasion into the resected septum and atrial wall. It is important to prevent tumor embolization to the pulmonary artery or strangulation into the right ventricle during surgery on this type of huge right atrial myxoma.
一名72岁女性成功切除巨大右房黏液瘤。患者有轻微咳嗽，心脏轮廓异常，血沉升高。经超声心动图和血管造影确诊为右房黏液瘤。腔静脉造影显示巨大肿块占据整个右心房。该肿瘤由发自右冠状动脉和回旋支冠状动脉的发育良好的供血动脉供血，显示丰富的肿瘤血管。连同附着肿瘤的房间隔和右房游离壁一并切除该肿瘤。用特氟龙织物补片封闭房间隔缺损，右房游离壁缺损采用Z成形术直接缝合修复。术后过程顺利。病理检查显示黏液瘤未侵犯切除的间隔和心房壁。在这类巨大右房黏液瘤手术过程中，预防肿瘤栓塞至肺动脉或绞窄入右心室很重要。
