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经手术治疗的组织学良性心脏黏液瘤的临床特征、诊断方法及结果

Clinical characteristics, diagnostic methods and results of surgically treated histologically benign cardiac myxomas.

作者信息

Görür Durmuş Alper, Şaşkin Hüseyin

机构信息

Cardiovascular Surgery Clinic, Derince Training and Research Hospital, Health Sciences University, Kocaeli, Turkey. Email:

Cardiovascular Surgery Clinic, Derince Training and Research Hospital, Health Sciences University, Kocaeli, Turkey.

出版信息

Cardiovasc J Afr. 2024;35(1):27-34. doi: 10.5830/CVJA-2022-069. Epub 2023 Feb 8.

Abstract

BACKGROUND

Myxomas are primary cardiac tumours that may be detected incidentally due to embolic events, intracardiac obstructive features or non-specific structural symptoms. The aim of this study was to share our experience of clinical features, diagnostic methods, surgical procedures and postoperative follow up of surgically treated cardiac myxomas.

METHODS

Data of 34 patients who underwent surgery for a cardiac myxoma between January 2006 and June 2022 were retrospectively analysed. Group 1 ( = 19) consisted of patients who were symptomatic and group 2 ( = 15) patients were asymptomatic. The medical records of the patients, their clinical status, diagnostic methods, operation information and postoperative course data were collected and recorded.

RESULTS

A total of 34 patients (16 female; mean age 54.5 ± 8.8 years) underwent cardiac myxoma resection with cardiopulmonary bypass. Fifteen (44.1%) patients were diagnosed incidentally with asymptomatic myxoma. An additional cardiac surgical procedure was performed in six patients (17.7%). The 34 cardiac myxomas that were surgically resected were localised in the left atrium in 25 patients (73.5%) and in the right atrium in nine patients (26.5%). Patients' most common symptoms were dyspnoea (42.1%), palpitations (21.1%), ischaemic stroke (15.8%) and syncope (10.5%). There was no incident of 30-day mortality and no recurrence was observed in any patient during the follow-up period. The duration of surgical intervention in symptomatic patients was significantly shorter than in asymptomatic patients ( = 0.0001), but there was no statistical difference in terms of characteristics.

CONCLUSIONS

Myxomas are benign tumours, but they are serious pathologies that require early treatment because of signs of obstruction, embolic complications and confusion, with left atrial thrombus in the differential diagnosis.

摘要

背景

黏液瘤是原发性心脏肿瘤,可能因栓塞事件、心内梗阻特征或非特异性结构症状而偶然被发现。本研究的目的是分享我们在手术治疗心脏黏液瘤的临床特征、诊断方法、手术过程及术后随访方面的经验。

方法

回顾性分析2006年1月至2022年6月期间34例行心脏黏液瘤手术患者的数据。第1组(n = 19)为有症状患者,第2组(n = 15)为无症状患者。收集并记录患者的病历、临床状况、诊断方法、手术信息及术后病程数据。

结果

共有34例患者(16例女性;平均年龄54.5±8.8岁)在体外循环下接受了心脏黏液瘤切除术。15例(44.1%)患者偶然被诊断为无症状黏液瘤。6例患者(17.7%)还接受了额外的心脏手术。34例手术切除的心脏黏液瘤中,25例(73.5%)位于左心房,9例(26.5%)位于右心房。患者最常见的症状为呼吸困难(42.1%)、心悸(21.1%)、缺血性卒中(15.8%)和晕厥(10.5%)。无30天死亡病例,随访期间未观察到任何患者复发。有症状患者的手术干预时间明显短于无症状患者(P = 0.0001),但在特征方面无统计学差异。

结论

黏液瘤是良性肿瘤,但由于存在梗阻迹象、栓塞并发症及鉴别诊断时需考虑左心房血栓等情况,它们是需要早期治疗的严重病变。

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