Bini R M, Westaby S, Bargeron L M, Pacifico A D, Kirklin J W
J Am Coll Cardiol. 1983 Aug;2(2):351-7. doi: 10.1016/s0735-1097(83)80174-0.
Seven children with primary cardiac tumors are discussed. The diagnosis was achieved by cardiac catheterization in all seven patients. In four patients, surgical excision was undertaken with one long-term good result. One of the other three surgical patients died of acute heart failure at the discontinuation of cardiopulmonary bypass. One of the other two surgical patients died suddenly late postoperatively, presumably from arrhythmia. The other, affected by fibrosarcoma, also died suddenly while undergoing chemotherapy. The histologic findings on the tumor masses were available in six patients. There were three rhabdomyomas, one fibrosarcoma, one fibroma and one hamartomatous mass. In one patient with tuberous sclerosis, a presumptive diagnosis of rhabdomyoma was made clinically on the basis of multiple masses infiltrating the left ventricle. Two-dimensional echocardiography is the best noninvasive tool to determine the extent and location of the tumor and suitability for surgery. When surgery is indicated, cardiac catheterization for pressure data is also required. Surgery is recommended in symptomatic solitary lesions that most likely are fibromas and have an overall good surgical outcome.
本文讨论了7例原发性心脏肿瘤患儿。所有7例患者均通过心导管检查确诊。4例患者接受了手术切除，其中1例长期效果良好。另外3例手术患者中，1例在体外循环停止后死于急性心力衰竭。另外2例手术患者中，1例在术后晚期突然死亡，推测死于心律失常。另1例患有纤维肉瘤的患者在化疗期间也突然死亡。6例患者有肿瘤肿块的组织学检查结果。其中有3例横纹肌瘤、1例纤维肉瘤、1例纤维瘤和1例错构瘤样肿块。1例结节性硬化症患者，临床上根据多个肿块浸润左心室，初步诊断为横纹肌瘤。二维超声心动图是确定肿瘤范围和位置以及是否适合手术的最佳无创工具。当需要手术时，也需要进行心导管检查以获取压力数据。对于症状性孤立性病变，若最有可能为纤维瘤且手术总体效果良好，建议进行手术。
