Wei Ke, Guo Hong-Wei, Fan Shu-Ya, Sun Xiao-Gang, Hu Sheng-Shou
Department of Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Card Surg. 2019 Jan;34(1):14-19. doi: 10.1111/jocs.13980. Epub 2019 Jan 9.
We sought to analyze clinical features and surgical results of 10 cases of cardiac myxomas in Carney complex (CNC).
Between January 2003 and December 2013, 10 patients with cardiac myxomas in CNC underwent surgical resection. Associated cardiac lesions included moderate and severe mitral regurgitation in two cases, and moderate tricuspid regurgitation in one case. Age, gender, the incidence of arterial embolism, the rate of multiple cardiac myxomas, and the recurrence rate after resections of cardiac myxoma were compared between isolated cardiac myxomas and cardiac myxomas in CNC.
The incidence of cardiac myxoma in CNC was 1.74% (10/574). There were no deaths following surgery. There was one late death due to cerebral embolism 40 months following a reoperation (10%). A significant difference was found in the age, the incidence of arterial embolism, the rate of multiple cardiac myxomas, and the recurrence rate after resection of cardiac myxoma between cardiac myxoma in CNC and isolated cardiac myxoma (P < 0.05). There was no significant difference in gender between cardiac myxoma in CNC and isolated cardiac myxoma (P > 0.05).
Complex myxomas in CNS present at an earlier age, are more prevalent in women than in men, are more often multicentric, with a higher rate of arterial embolism and a high recurrence rate after resection. Close follow-up for cardiac myxoma in CNC after surgery is necessary due to the high recurrence rate.
我们试图分析10例卡尼综合征(CNC)患者心脏黏液瘤的临床特征及手术结果。
2003年1月至2013年12月期间,10例患有CNC心脏黏液瘤的患者接受了手术切除。相关心脏病变包括2例中度和重度二尖瓣反流,以及1例中度三尖瓣反流。比较孤立性心脏黏液瘤与CNC患者心脏黏液瘤之间的年龄、性别、动脉栓塞发生率、多发性心脏黏液瘤发生率以及心脏黏液瘤切除术后的复发率。
CNC患者心脏黏液瘤的发生率为1.74%(10/574)。术后无死亡病例。再次手术后40个月有1例因脑栓塞晚期死亡(10%)。CNC患者心脏黏液瘤与孤立性心脏黏液瘤在年龄、动脉栓塞发生率、多发性心脏黏液瘤发生率以及心脏黏液瘤切除术后的复发率方面存在显著差异(P < 0.05)。CNC患者心脏黏液瘤与孤立性心脏黏液瘤在性别方面无显著差异(P > 0.05)。
CNC患者的复杂性黏液瘤发病年龄较早,女性比男性更常见,多为多中心性,动脉栓塞发生率较高,切除术后复发率也较高。由于复发率高,CNC患者心脏黏液瘤术后有必要密切随访。