Mkalaluh Sabreen, Szczechowicz Marcin, Torabi Saeed, Dib Bashar, Sabashnikov Anton, Mashhour Ahmed, Karck Matthias, Weymann Alexander
Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany.
Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany.
Med Sci Monit Basic Res. 2017 Jul 14;23:258-263. doi: 10.12659/msmbr.904881.
BACKGROUND We reviewed our clinical experience with cardiac papillary fibroelastoma from 2005 to 2017. The objective of this study was to investigate the clinical and operative data, as well as the early survival rate and immediate postoperative complications. MATERIAL AND METHODS We performed a retrospective analysis of 11 patients (eight males and three females) who underwent resection of cardiac papillary fibroelastoma in our institution. RESULTS Mean age at tumor diagnosis was 60±14 years. The mean dimension of the tumor was 14±11 mm. The most common symptoms were dyspnea, palpitation, and angina pectoris, while one patient had recurrent fever attacks and another patient had a transient ischemic attack. Two patients had concomitant malignant tumors (cervical and colon carcinoma) and another two had concomitant benign neoplasms (liver cyst and thyroid adenoma). Bypass and cross clamp times were 77±32 minutes and 54±18 minutes, respectively. The tumors were found predominantly on cardiac valves (n=7). In eight cases, only tumor extirpation was performed, whereas in the other three cases, the valves had to be replaced. The mean intensive care unit length of stay was 1.1±0.3 days and there was no in-hospital mortality. All patients were alive at one-year follow-up and the survival rate was 91% in the mean follow-up period of 4.15 years. CONCLUSIONS The surgical treatment of cardiac papillary fibroelastoma was curative and safe. Thus, potential complications such as embolization or mechanical irritation of the valves can be avoided without high surgical risk.
背景 我们回顾了2005年至2017年期间我们对心脏乳头状纤维弹性瘤的临床经验。本研究的目的是调查临床和手术数据,以及早期生存率和术后即刻并发症。
材料与方法 我们对在我院接受心脏乳头状纤维弹性瘤切除术的11例患者(8例男性和3例女性)进行了回顾性分析。
结果 肿瘤诊断时的平均年龄为60±14岁。肿瘤的平均大小为14±11毫米。最常见的症状是呼吸困难、心悸和心绞痛,而1例患者有反复发热发作,另1例患者有短暂性脑缺血发作。2例患者伴有恶性肿瘤(宫颈癌和结肠癌),另外2例伴有良性肿瘤(肝囊肿和甲状腺腺瘤)。体外循环和主动脉阻断时间分别为77±32分钟和54±18分钟。肿瘤主要位于心脏瓣膜(n = 7)。8例仅进行了肿瘤切除,而其他3例则必须更换瓣膜。重症监护病房的平均住院时间为1.1±0.3天,无院内死亡。所有患者在1年随访时均存活,在平均4.15年的随访期内生存率为91%。
结论 心脏乳头状纤维弹性瘤的手术治疗是治愈性且安全的。因此,可以避免诸如栓塞或瓣膜机械刺激等潜在并发症,而无需承担高手术风险。