Bjessmo S, Ivert T
Department of Thoracic Surgery, Karolinska Hospital, Stockholm, Sweden.
Ann Thorac Surg. 1997 Mar;63(3):697-700. doi: 10.1016/s0003-4975(96)01368-9.
Cardiac myxomas were resected in 63 patients, including the first successful procedure in the world.
Patient data and data obtained during follow-up of the survivors were reviewed.
Preoperatively, valve obstruction occurred in 56% and emboli in 32% of the patients. The myxomas were located in the left atrium in 88%, right atrium in 10%, and both atria in 1 patient (1.6%). One patient died early, and 5 died late. The 20-year survival rate was 85%. At a median of 13 years (range, 1 month to 42 years) after resection, 26% of the survivors reported having various cardiopulmonary symptoms, 5% had had thromboembolic events, and 69% were asymptomatic. After 2 years, there was a recurrence in a young woman who had had a multifocal myxoma at the time of the primary operation. No other evidence of recurrence was found at autopsy or during repeat echocardiography in the remaining patients during an observation period of 787 patient-years.
Surgical resection of a single myxoma is a safe and effective treatment, with a low risk of recurrence. After uncomplicated resection, the frequency with which postoperative echocardiography is performed should be limited.
63例患者接受了心脏黏液瘤切除术，其中包括世界上首例成功手术。
回顾患者数据及存活患者随访期间获得的数据。
术前，56%的患者出现瓣膜梗阻，32%的患者出现栓塞。黏液瘤位于左心房者占88%，位于右心房者占10%，1例患者（1.6%）位于双心房。1例患者早期死亡，5例患者晚期死亡。20年生存率为85%。切除术后中位时间为13年（范围1个月至42年），26%的存活患者报告有各种心肺症状，5%发生过血栓栓塞事件，69%无症状。2年后，1例在初次手术时患有多灶性黏液瘤的年轻女性出现复发。在787患者年的观察期内，其余患者在尸检或重复超声心动图检查中未发现其他复发证据。
单发黏液瘤手术切除是一种安全有效的治疗方法，复发风险低。在无并发症的切除术后，术后超声心动图检查的频率应受到限制。
