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[儿童二尖瓣黏液瘤。关于一例手术病例]

[Myxoma of the mitral valve in a child. Apropos of an operated case].

作者信息

Almange C, Revillon L, Michardière A, Stephan P, Rioux C

出版信息

Arch Mal Coeur Vaiss. 1980 May;73(5):554-9.

PMID:6772135
Abstract

The case of an 8 year old child with a symtomless murmur of mitral incompetence is reported. Echocardiography showed the presence of an intracardiac tumour, a mass of dense echos between the two mitral leaflets being recorded; multiscan examination suggested insertion on the anterior mitral leaflet. The tumour and its pedicle were resected, causing some loss of valvular tissue, which required repair with a strip of pericardium. This would appear to be the first reported case of mitral valve myxoma in children. Left atrial myxoma, the commonest cardiac tumour, is rarely observed before 15 years of age; insertion on the mitral valve itself is rare at any age. The site of insertion is determined by quite separate echocardiographic criteria compared to left atrial myxoma. This is important as surgery may sacrifice the mitral valve, and mitral valve replacement may be needed; valvuloplasty should be attempted in this age group, despite the risk of tumour recurrence, which is porbably greater with this unusual location.

摘要

报告了一例8岁儿童患有二尖瓣关闭不全无症状杂音的病例。超声心动图显示心内有肿瘤,记录到二尖瓣两叶之间有一团密集回声;多切面检查提示肿瘤附着于二尖瓣前叶。切除肿瘤及其蒂部导致部分瓣膜组织缺失,需要用一条心包进行修复。这似乎是首例儿童二尖瓣黏液瘤的报道病例。左心房黏液瘤是最常见的心脏肿瘤,15岁之前很少见;肿瘤附着于二尖瓣本身在任何年龄都很罕见。与左心房黏液瘤相比,肿瘤附着部位由完全不同的超声心动图标准确定。这一点很重要,因为手术可能会牺牲二尖瓣,可能需要进行二尖瓣置换;尽管该年龄段存在肿瘤复发风险(这种不寻常的位置可能复发风险更大),但仍应尝试进行瓣膜成形术。

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