Dein J R, Frist W H, Stinson E B, Miller D C, Baldwin J C, Oyer P E, Jamieson S, Mitchell R S, Shumway N E
J Thorac Cardiovasc Surg. 1987 Apr;93(4):502-11.
Forty-two patients underwent resection of primary cardiac neoplasms at Stanford University Medical Center and the Palo Alto Veterans Administration Medical Center between 1961 and 1986. A total of 27 atrial myxomas, seven benign nonmyxomatous tumors, and eight malignant tumors were resected. The mean age was 47 years (range 8 to 79) in 27 female and 15 male patients. The clinical presentations included congestive heart failure in 24 patients, palpitations in nine, neurologic symptoms in six, recurrent cardiac tamponade in three, vasculitis in two, and chest pain in two. Thirty-one of 34 benign lesions were completely resected, although one patient required cardiac transplantation to resect completely an "inoperable" benign tumor. All gross tumor was resected in four of eight patients with malignant lesions. All patients survived operation, but three with malignant disease died within 30 days. Late outcome was known for 41 of 42 (98%) patients. Total follow-up for the series was 200.1 patient-years, for an average of 4.7 years (range 1 month to 18 years). Excellent early and late results were obtained in patients with benign lesions, as there was no known tumor recurrence even if resection was incomplete. Effective palliation and local control of disease is possible with extensive resection of malignant primary tumors, but more effective adjuvant therapy will be necessary to improve long-term prognosis.
1961年至1986年间，42例患者在斯坦福大学医学中心和帕洛阿尔托退伍军人管理局医疗中心接受了原发性心脏肿瘤切除术。共切除27例心房黏液瘤、7例良性非黏液性肿瘤和8例恶性肿瘤。27例女性和15例男性患者的平均年龄为47岁（范围8至79岁）。临床表现包括24例充血性心力衰竭、9例心悸、6例神经症状、3例复发性心脏压塞、2例血管炎和2例胸痛。34例良性病变中的31例被完全切除，尽管有1例患者需要心脏移植才能完全切除一个“无法手术”的良性肿瘤。8例恶性病变患者中有4例切除了所有肉眼可见的肿瘤。所有患者均存活至手术结束，但3例恶性疾病患者在30天内死亡。42例患者中有41例（98%）的远期预后已知。该系列患者的总随访时间为200.1患者年，平均4.7年（范围1个月至18年）。良性病变患者获得了良好的早期和晚期结果，因为即使切除不完全也没有已知的肿瘤复发。对恶性原发性肿瘤进行广泛切除可以有效地缓解症状并局部控制疾病，但需要更有效的辅助治疗来改善长期预后。
