Dragoĭchev Ch, Pavlov Ts, Donova T, Georgiev G, Ovanesian Kh
Vutr Boles. 1980;19(6):36-45.
The difficulties in the diagnosis of left auricle myxoma are discussed, proceeding from seven patients, observed by the authors. In two of them the diagnosis was confirmed by EchoCG and intracardial investigation (left atriography), in three--it was realized by exploratory thoracotomy, and in one of them proceeded directly into operation with extracorporal circulation (ECC), the second was radically operated (with ECC) after one month and the third died during operation due to acute obturation of mitral ostium by an extremely big myxoma; the other two patients were also successfully operated, the diagnosis being preoperatively made. Two patients died of cardiac failure, their diagnosis made at necropsy. The atypical and fast development of a mitral defect, progressing cardiac decompensation unsusceptible to treatment, are stressed to have a diagnostic significance in myxoma of left auricle as well as the effect of body position upon the morbid symptoms, discrepancy between the size of the left auricle and the type and stage of the manifested valvular disease, corresponding to the ECG manifestation of the same in the juxtaposition with the manifestation of the ventricular hypertrophy, etc. EchoCG examination and the left (contrast) atriography are of a high diagnostic value.
本文从作者观察的7例患者出发，探讨了左心房黏液瘤的诊断难点。其中2例经超声心动图（EchoCG）和心内检查（左心房造影）确诊；3例通过剖胸探查确诊；1例直接进行体外循环（ECC）手术，第2例在1个月后进行了根治性手术（采用ECC），第3例在手术期间因巨大黏液瘤急性阻塞二尖瓣口死亡；另外2例患者也成功接受了手术，术前已确诊。2例患者死于心力衰竭，尸检时确诊。强调二尖瓣缺损的非典型和快速发展、进行性心力衰竭且对治疗无反应，在左心房黏液瘤中具有诊断意义，以及体位对病态症状的影响、左心房大小与所表现瓣膜疾病的类型和阶段之间的差异、与心室肥大表现并列的相应心电图表现等。EchoCG检查和左（造影）心房造影具有很高的诊断价值。
