Di Giammarco Gabriele, Marchetti Marziale, Foschi Massimiliano, Marinelli Daniele, Micucci Donato, Buca Danilo, Leombroni Martina, Di Mauro Michele
Department of Cardiac Surgery, "G. D'Annunzio" University, Chieti, Pescara, Italy.
Department of Gynecology and Obstetrics, "G. D'Annunzio" University, Chieti, Pescara, Italy.
J Cardiol Cases. 2015 Sep 19;13(3):67-69. doi: 10.1016/j.jccase.2015.08.012. eCollection 2016 Mar.
We report a case of a woman at 32nd gestational week, admitted for resting dyspnea, showing left atrial (LA) myxoma. Cardiac myxomas are the most common primary benign tumors of the heart. The incidence of cardiac myxomas diagnosed in pregnancy is extremely low. In the present case, cesarean delivery and concomitant surgical resection of LA myxoma were both delayed after corticosteroid prophylaxis in order to reduce neonatal cerebral, intestinal, and pulmonary complications. < The rarity of these cases makes the management more related to anecdotal experiences. In our case, the gestational age was lower than 34th week, but the fetus was sufficiently large to be delivered before heart surgery with low risk of prematurity complications after an adequate corticosteroid prophylaxis. A waiting approach with several days of corticosteroid prophylaxis was successfully adopted. When the pregnant hemodynamics are stable with low risk of complications, heart surgery should be delayed after corticosteroid prophylaxis.>.
我们报告一例孕32周的女性,因静息性呼吸困难入院,诊断为左心房黏液瘤。心脏黏液瘤是最常见的原发性心脏良性肿瘤。孕期诊断出心脏黏液瘤的发生率极低。在本病例中,为减少新生儿脑、肠和肺部并发症,在给予皮质类固醇预防后,剖宫产及同期左心房黏液瘤手术切除均被推迟。<这些病例的罕见性使得治疗更多地与轶事性经验相关。在我们的病例中,孕周低于34周,但胎儿足够大,可以在心脏手术前分娩,且在给予充分的皮质类固醇预防后早产并发症风险较低。成功采用了给予几天皮质类固醇预防的等待方法。当妊娠血流动力学稳定且并发症风险较低时,应在给予皮质类固醇预防后推迟心脏手术。>