心脏黏液瘤的手术经验：长期随访
Surgical experience with intracardiac myxomas: long-term follow-up.
作者信息
Bhan A, Mehrotra R, Choudhary S K, Sharma R, Prabhakar D, Airan B, Kumar A S, Venugopal P
机构信息
Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi.
出版信息
Ann Thorac Surg. 1998 Sep;66(3):810-3. doi: 10.1016/s0003-4975(98)00591-8.
BACKGROUND
Myxomas are the most common benign intracardiac tumors. This report summarizes our 20-year experience with these tumors.
METHODS
Sixty-six patients (25 male) with a median age of 39 years (range, 6 to 70 years) underwent surgical excision of primary or recurrent intracardiac myxomas during the years 1976 to 1996. Symptom duration ranged from 2 to 8 months. There were 55 left atrial myxomas, 10 right atrial myxomas, and 1 biatrial myxoma. Three of the patients were in one family. The surgical approach comprised complete wide excision.
RESULTS
There were two early deaths. Late follow-up is 89% (57/64) complete. There was one late death, which was not due to a cardiac cause. Echocardiography at a mean follow-up of 66.9 months (range, 7 to 241 months) showed no recurrence of sporadic myxomas. However, 2 of the 3 patients with familial myxomas had recurrence.
CONCLUSIONS
Surgical excision of atrial myxoma gives excellent short-term and long-term results leading to eventual cure of nonfamilial myxomas. However, familial myxomas retain a strong tendency to recur even 20 years after excision.
背景
黏液瘤是最常见的心脏良性肿瘤。本报告总结了我们20年来对这些肿瘤的治疗经验。
方法
1976年至1996年期间，66例患者（25例男性）接受了原发性或复发性心脏黏液瘤的手术切除，中位年龄39岁（范围6至70岁）。症状持续时间为2至8个月。其中左心房黏液瘤55例，右心房黏液瘤10例，双心房黏液瘤1例。3例患者来自同一个家庭。手术方式为完整广泛切除。
结果
有2例早期死亡。晚期随访完成率为89%（57/64）。有1例晚期死亡，并非心脏原因所致。平均随访66.9个月（范围7至241个月）时的超声心动图检查显示，散发性黏液瘤无复发。然而，3例家族性黏液瘤患者中有2例复发。
结论
心房黏液瘤手术切除可获得良好的短期和长期效果，最终治愈非家族性黏液瘤。然而，家族性黏液瘤即使在切除20年后仍有很强的复发倾向。
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