右房黏液瘤的临床特征及外科治疗结果

Mid-term Outcome of Surgical Resection of Right Atrial Myxoma

目的总结右房黏液瘤的临床特征和外科治疗结果。方法2007年1月至2012年12月共28例右房黏液瘤患者行黏液瘤切除术,女性16例,男性12例;年龄8~79岁,平均(46.3±14.8)岁。合并病变:中重度三尖瓣关闭不全4例,冠心病5例,肺动脉栓塞1例,同期外科手术。对27例(96.43%)患者随访70~138个月,平均(95.8±31.1)个月。总结右房黏液瘤在心脏黏液瘤中的比率、附着部位、近期及中期疗效。结果右房黏液瘤占心脏黏液瘤的7.89%。最常见的附着部位是房间隔。所有患者术后早期无死亡。1例术后死于肺癌,余患者心功能(NYHA分级)Ⅰ-Ⅱ级。结论右房黏液瘤外科治疗中期结果满意,远期疗效需进一步随访。

Objective To review and investigate the clinical features and surgical results of right atrial myxomas. Methods Between January 2007 and December 2012, 28 patients with right atrial myxomas underwent surgical resection. There were 16 males and 12 females with a mean age of (46.3±14.8) years (range, 8-79 years). Associated cardiac lesions included moderate and severe tricuspid regurgitation in 4 cases, coronary atherosclerotic heart disease in 5 cases, and pulmonary embolism in 1 case. The coexisting anomalies were corrected at the same time. 27 patients (96.43%) were followed up for (95.8 ±31.1) months (range, 70-138 months). The proportion, attachment site, short-term and medium-term prognosis of right atrial myxoma in cardiac myxoma were summarized. Results The incidence of right atrial myxomas among sporadic cardiac myxoma was 7.89%. The most common attached sites of right atrial myxomas were atrial septum (60.71%), followed by free wall of right atrium (28.57%). There was no early death after operation. One patient died of lung cancer 34 months after resection. All survival patients were in the New York Heart Association (NYHA) functional class Ⅰ and Ⅱ. Conclusion Surgical resection of the right atrial myxoma results in good mid-term results. Longer follow-up is needed to determine the efficacy of this procedure as this cohort of patients.