Suzuki Kenji, Sakamoto Shun-Ichiro, Hiromoto Atsushi, Maeda Motohiro, Yamaguchi Takako, Yamada Naoki, Ueda Hitomi, Matsuyama Takayoshi, Osaka Shin-Ichi, Ishii Yosuke
Department of Cardiovascular Surgery, Nippon Medical School Musashikosugi Hospital, Kawasaki 211-8533, Japan.
Department of Nursing, Nippon Medical School Musashikosugi Hospital, Kawasaki 211-8533, Japan.
J Clin Med. 2024 Sep 18;13(18):5532. doi: 10.3390/jcm13185532.
Cardiac neoplasms may cause life-threatening symptoms associated with cerebral infarction, ventricular arrhythmias, and heart failure. Emergency surgery or preoperative treatment may be required for these patients. However, no study has reported the surgical outcomes in cases involving cardiac neoplasms with life-threatening complications. The current study investigated the mid- to long-term outcomes of surgery in patients with cardiac neoplasms in life-threatening conditions. : This study retrospectively analyzed 36 consecutive patients who underwent resection for cardiac neoplasms with life-threatening cardiovascular, respiratory, and cerebral nervous system complications from January 2000 to December 2022. Their mean age at surgery was 54.9 years. In terms of fatal events, one patient who experienced a ventricular tachycardia storm caused by a left ventricular neoplasm was placed under deep sedation and managed with a ventilator preoperatively. Seven patients who presented with limb motor paralysis and visual defects had cerebral infarction. Two of the seven patients with cerebral infarction received cerebrovascular treatment before cardiac surgery. : During the follow-up period, cerebral- and cardiovascular-related deaths were not recorded. All postoperative cerebral and cardiovascular complications were new-onset cerebral infarction (n = 2) (with symptoms that improved during the long term). The mean follow-up period was 6.2 years. The 5- and 10-year survival rates of all patients were 89.8% and 78.7%, respectively. There were no significant differences in postoperative prognosis between patients with preoperative cerebral infarctions and those without. : The long-term surgical outcome of patients with life-threatening symptomatic cardiac neoplasm was good. Thus, preoperative complications did not affect prognosis.
心脏肿瘤可能会引发与脑梗死、室性心律失常和心力衰竭相关的危及生命的症状。这些患者可能需要进行急诊手术或术前治疗。然而，尚无研究报道涉及伴有危及生命并发症的心脏肿瘤病例的手术结果。本研究调查了处于危及生命状况的心脏肿瘤患者手术的中长期结果。本研究回顾性分析了2000年1月至2022年12月期间连续36例因危及生命的心血管、呼吸和中枢神经系统并发症而接受心脏肿瘤切除术的患者。他们手术时的平均年龄为54.9岁。在致命事件方面，一名因左心室肿瘤引发室性心动过速风暴的患者术前接受了深度镇静并使用呼吸机进行管理。7例出现肢体运动麻痹和视觉缺陷的患者发生了脑梗死。7例脑梗死患者中有两例在心脏手术前接受了脑血管治疗。在随访期间，未记录到与脑和心血管相关的死亡病例。所有术后脑和心血管并发症均为新发脑梗死（n = 2）（症状在长期内有所改善）。平均随访期为6.2年。所有患者的5年和10年生存率分别为89.8%和78.7%。术前有脑梗死的患者与无脑梗死的患者术后预后无显著差异。有危及生命症状的心脏肿瘤患者的长期手术结果良好。因此，术前并发症不影响预后。
