Chakfé N, Kretz J G, Valentin P, Geny B, Petit H, Popescu S, Edah-Tally S, Massard G
Department of Cardiovascular Surgery, Les Hopitaux Universitaires de Strasbourg, France.
Ann Thorac Surg. 1997 Sep;64(3):872-7. doi: 10.1016/s0003-4975(97)00695-4.
Myxomas rarely are located on the mitral valve. We report the case of a 44-year-old man operated on successfully with mitral valve conservation, which is the 21st case of mitral valve myxoma reported in the western literature. Among the cases reported in the literature, the diagnosis was made at the time of autopsy in 6 cases, with premortem heart failure in 1 case. A clinical diagnosis was made in 15 cases on the basis of the following symptoms: peripheral embolism in 9 cases, cardiac signs in 4 cases, and constitutional manifestations in 2 cases. The clinical presentation of mitral valve myxoma differs slightly from that of other cardiac myxomas in that it has a lower incidence of constitutional manifestations. The gold standard for noninvasive diagnosis and localization of cardiac myxomas is transesophageal echocardiography. It allows for the detection of early, small valvular tumors and may help to characterize better their location and echostructure, facilitating the choice of an optimal surgical approach through preoperative study of the integrity and mobility of the valve. Conservative operative treatment by resection of the area of implantation of the myxoma followed by suture repair of the valve and annuloplasty may be recommended as the most appropriate treatment option for this rare condition.
黏液瘤很少位于二尖瓣。我们报告了一例44岁男性成功接受保留二尖瓣手术的病例，这是西方文献中报道的第21例二尖瓣黏液瘤病例。在文献报道的病例中，6例在尸检时确诊，1例生前出现心力衰竭。15例根据以下症状做出临床诊断：9例出现周围栓塞，4例有心脏体征，2例有全身表现。二尖瓣黏液瘤的临床表现与其他心脏黏液瘤略有不同，其全身表现的发生率较低。经食管超声心动图是心脏黏液瘤无创诊断和定位的金标准。它能够检测早期、小的瓣膜肿瘤，并有助于更好地确定其位置和回声结构，通过术前研究瓣膜的完整性和活动度，便于选择最佳手术方法。对于这种罕见疾病，推荐采用切除黏液瘤植入区域、随后进行瓣膜缝合修复和瓣环成形术的保守手术治疗作为最合适的治疗选择。
