Center of Cardiovascular Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China.
Department of Radiology, Xinqiao Hospital, Army Medical University, Chongqing, China.
Cardiology. 2024;149(2):147-154. doi: 10.1159/000535656. Epub 2024 Feb 28.
The aim of the study was to investigate the clinical characteristics, surgical treatment, and long-term efficacy of primary right heart tumors.
This study is retrospective analysis of the clinical data of 70 patients with primary right heart tumors admitted to our department between 1980 and 2022 (observation group) and 70 patients with left heart tumors during the same period (control group). The surgical treatment was performed under cardiopulmonary bypass after differential diagnosis by echocardiography, cardiac CTA, and PET-CT before the surgery. The perioperative characteristics, recurrence rate, and long-term survival rates of right heart tumor versus left heart tumor were compared.
The most common pathological types of right heart tumors were myxoma (60%), lipoma (8.57%), and papillary elastofibroma (7.14%). During the perioperative period, there were 1 case of systemic embolism in the observation group, compared with 6 in the control group (p = 0.026), 13 cases of malignant tumor in the observation group versus 1 in the control group (p = 0.01). During the follow-up period, there were 15 cases of tumor recurrence and 17 cases of death in the observation group versus 4 (p = 0.002) and 7 in the control group (p = 0.006), comparatively.
Compared with left heart tumors, primary right heart tumors had a higher incidence of malignant tumors and a lower risk of systemic embolism during perioperative period. During the follow-up period, primary right heart tumors had a higher rate of tumor recurrence and a lower long-term survival rate.
本研究旨在探讨原发性右心肿瘤的临床特征、外科治疗及长期疗效。
本研究回顾性分析了 1980 年至 2022 年期间我科收治的 70 例原发性右心肿瘤患者（观察组）和同期 70 例左心肿瘤患者（对照组）的临床资料。术前通过超声心动图、心脏 CTA 和 PET-CT 进行鉴别诊断后，在体外循环下行外科治疗。比较右心肿瘤与左心肿瘤的围手术期特点、复发率及长期生存率。
右心肿瘤最常见的病理类型为黏液瘤（60%）、脂肪瘤（8.57%）和乳头状弹力纤维瘤（7.14%）。观察组围手术期发生全身性栓塞 1 例，对照组 6 例（p = 0.026），观察组恶性肿瘤 13 例，对照组 1 例（p = 0.01）。随访期间，观察组肿瘤复发 15 例，死亡 17 例，对照组肿瘤复发 4 例，死亡 7 例（p = 0.002），对照组肿瘤复发 7 例（p = 0.006）。
与左心肿瘤相比，原发性右心肿瘤恶性肿瘤发生率较高，围手术期发生全身性栓塞的风险较低。在随访期间，原发性右心肿瘤的肿瘤复发率较高，长期生存率较低。
