Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste.
Cardiothoracovascular Department, Division of Cardiac Surgery, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste.
J Cardiovasc Med (Hagerstown). 2022 Nov 1;23(11):722-727. doi: 10.2459/JCM.0000000000001375. Epub 2022 Aug 31.
Cardiac tumors are rare and heterogeneous entities which still remain a diagnostic and therapeutic challenge. The treatment for most cardiac tumors is prompt surgical resection. We sought to provide an overview of surgical results from a series of consecutive patients treated at our tertiary care center during almost a 20-year experience.
In this single center study, 55 consecutive patients with diagnosis of cardiac tumor underwent surgical treatment from January 2002 to April 2021. Of these, 23 (42%) were male and the mean age was 62 ± 12 years. Fifteen (27%) patients were symptomatic at the time of the diagnosis, mostly for dyspnea and palpitations. The most frequent benign cardiac tumor was myxoma (32; 58%), occurring mainly in the left atrium (31; 97%). Pleomorphic sarcoma was the most frequent primary malignant cardiac tumor (4; 7%), mainly located in the ventricles (1; 25% in the left ventricle; 2; 50% in the right ventricle). In all cases of benign tumors surgery was successful with no relapses. Two (50%) pleomorphic sarcomas showed subsequent relapses. After a median follow-up of 44 months, 15 (27%) patients died. Although malignant tumors presented a limited survival, benign tumors showed a very good prognosis.
Cardiac tumors require a multidisciplinary approach to guarantee a prompt diagnosis and appropriate treatment. In our surgical experience, outcome after surgery of benign tumors was excellent, while malignant tumors had poor prognosis despite radical surgery.
心脏肿瘤是罕见且异质性的实体瘤，仍然是诊断和治疗的挑战。大多数心脏肿瘤的治疗方法是及时进行手术切除。我们旨在提供在我们的三级护理中心近 20 年的经验中，对一系列连续患者的手术结果的概述。
在这项单中心研究中，2002 年 1 月至 2021 年 4 月期间，有 55 例诊断为心脏肿瘤的连续患者接受了手术治疗。其中，23 例（42%）为男性，平均年龄为 62±12 岁。15 例（27%）患者在诊断时出现症状，主要表现为呼吸困难和心悸。最常见的良性心脏肿瘤是黏液瘤（32 例；58%），主要发生在左心房（31 例；97%）。多形性肉瘤是最常见的原发性恶性心脏肿瘤（4 例；7%），主要位于心室（1 例；25%在左心室；2 例；50%在右心室）。所有良性肿瘤的手术均成功，无复发。2 例（50%）多形性肉瘤随后复发。在中位数为 44 个月的随访中，有 15 例（27%）患者死亡。尽管恶性肿瘤的生存期有限，但良性肿瘤的预后非常好。
心脏肿瘤需要多学科方法来保证及时诊断和适当治疗。在我们的手术经验中，良性肿瘤手术后的结果极好，而恶性肿瘤尽管进行了根治性手术，预后仍较差。
