Gonzalez-Urquijo Mauricio, Valdes Francisco, Mertens Renato, Mariné Leopoldo, Vargas Jose Francisco, Bergoeing Michel
Department of Vascular and Endovascular Surgery, School of Medicine, Pontifical Catholic University of Chile, Santiago, Chile.
Vasc Specialist Int. 2024 Sep 12;40:28. doi: 10.5758/vsi.240048.
Uterine intravascular leiomyomatosis (IVL) with extension into the right heart is uncommon, with no more than 400 cases reported in the literature since 1907. The present study aims to report three patients with intracardiac IVL surgically treated in our institution, with long-term follow-up. Three female patients in their third to fifth decades of life, with a history of difficult hysterectomy due to extensive myomatosis, presented with symptoms of right-sided heart failure. Echocardiography and computed tomography were performed, where IVL extending from the pelvis into the right heart was observed. All three patients underwent a one-stage operation under extracorporeal circulation through a right auriculotomy and inferior vena cavotomy, accessed via a sterno-laparotomy. The tumors were extirpated without complications, with ligation of the vena cava or iliac vein. The patients at 10-, 13-, and 37-year follow-up were well and alive with mild lower extremities symptoms.
子宫血管内平滑肌瘤病（IVL）累及右心较为罕见，自1907年以来，文献报道不超过400例。本研究旨在报告在我们机构接受手术治疗并长期随访的3例心脏内IVL患者。3例年龄在三十至五十岁的女性患者，因广泛子宫肌瘤病史而有子宫切除困难史，出现右心衰竭症状。进行了超声心动图和计算机断层扫描，观察到IVL从盆腔延伸至右心。所有3例患者均通过胸骨-剖腹手术，经右心耳切开术和下腔静脉切开术在体外循环下进行一期手术。肿瘤被完整切除且无并发症，同时结扎了腔静脉或髂静脉。在10年、13年和37年随访时，患者情况良好，存活，下肢有轻度症状。
