心脏乳头状纤维弹力瘤临床特征及手术切除效果的初步分析

Clinical Features and Long-term Outcome After Surgical Resection for Patients With Cardiac Papillary Fibroelastomas

目的:分析心脏乳头状纤维弹力瘤(CPF)的临床特征和手术切除效果。方法:回顾性分析中国医学科学院阜外医院2002年1月至2020年5月间33例外科手术切除的CPF患者的临床资料,探讨该肿瘤的临床特征和手术切除效果。结果:本组33例患者外科术后均顺利出院。术后失访3例(9.10%),其余30例(90.90%)患者随访1~216个月,平均74.84个月,患者全部存活,无肿瘤复发。33例患者共有36处CPF起源,其中起源于瓣膜的CPF有26处(72.22%);起源于瓣膜的CPF中以二尖瓣为主(38.46%,10/26),其次为主动脉瓣和三尖瓣(均为26.92%,7/26),再次为肺动脉瓣(7.69%,2/26);2例患者为多处起源。结论:国人CPF多数起源于瓣膜表面,其中以二尖瓣为主。外科手术切除是CPF的有效治疗手段,中远期无复发。

Objectives:To analyze the clinical features and long-term outcome after surgical resection for patients with cardiac papillary fibroelastomas(CPF).Methods:We retrospectively analyzed the clinical data of 33 patients with CPF and received surgical resection in our center from January 2002 to May 2020.There were 12 males and 21 females.The median age was 55 years(ranging from 8 to 74 years old).All procedures were performed under cardiopulmonary bypass.All tumors were pathologically analyzed.All patients underwent postoperative ultrasound follow-up examination.Results:All patients were discharged without complications,three patients were lost to follow-up.Thirty patients were followed-up for 1-216 months(median 74.84 months),there was no death during follow up.There was also no tumor recurrence.There were totally 36 CPF origins,the location of CPF was as follows:valves(26/36,72,22%)including mitral valve(10/26,38.46%),aortic valve(7/26,26.92%),tricuspid valve(7/26,26.92%),and pulmonary valve(2/26,7.69%).The CPF location of other two cases were multiple-originated.Conclusions:The predominant location of Chinese CPF patients is the mitral valve,followed by aortic valve and tricuspid valve.Surgical resection of CPF is an effective therapy option with satisfactory mid-and long-term results and there is no tumor recurrence post-surgery in this patient cohort.