PDF(Pubmed)
Abstract：
Cardiac lipomas are generally asymptomatic even in large dimensions. Echocardiograms can identify tumors, but cardiac magnetic resonance imaging or cardiac computerized tomography can differentiate cardiac lipomas from other cardiac tumors. The present study is a case report of an asymptomatic 30-year-old man diagnosed with atrial lipoma. The patient received cardiac surgery and the intervention consisted of exclusion of the right atrial (RA) tumor and reconstruction of the right atrium with \'XenoSure\' patch in extracorporeal circulation through a minimally invasive approach. A short PubMed literature review was performed and 26 cases of RA lipomas with available details were found. Cardiac tumors may cause clinical presentation through different pathways. Symptoms related to an RA lipoma were present in 21 out of 26 patients (80%). The symptoms varied greatly, dyspnea being the most common of them. In one case, the lipoma was found during the autopsy of a patient after sudden death. Large cardiac lipomas can lead to complications such as obstruction of ventricular outflow tract, electric disorders, embolism or pericardial effusion. Obstruction of the right ventricular outflow tract was reported in 11 out of 26 patients (42%) diagnosed with RA lipoma. Generally, atrial lipoma can have various sizes. The most useful imaging technique was transthoracic echocardiography. Accurate diagnosis and evaluation of cardiac lipoma is dependent on multimodality imaging methods, including cardiac magnetic resonance. Surgery is the treatment of choice, but the risk-benefit ratio must be considered, and shared decision making must be taken into account. The present review data showed that 23 out of 25 patients (92%) underwent surgery. Among these patients, only 1 out of 23 received a minimally invasive approach in 2021. Cardiac lipomas are rare entities, usually asymptomatic, that can occur at any age. The most useful diagnostic method of cardiac tumors is echocardiography, but nuclear magnetic resonance can also specify the type and characteristics of tumors.
摘要：
心脏脂肪瘤通常即使在大尺寸下也无症状。超声心动图可以识别肿瘤，但是心脏磁共振成像或心脏计算机断层扫描可以将心脏脂肪瘤与其他心脏肿瘤区分开来。本研究是一例无症状的30岁男性诊断为心房脂肪瘤的病例报告。患者接受了心脏手术，介入治疗包括排除右心房（RA）肿瘤，并通过微创方法在体外循环中使用“XenoSure”补片重建右心房。进行了简短的PubMed文献综述，发现了26例RA脂肪瘤，并提供了详细信息。心脏肿瘤可通过不同途径引起临床表现。26例患者中有21例（80％）存在与RA脂肪瘤相关的症状。症状变化很大，呼吸困难是其中最常见的。在一个案例中,一名病人突然死亡后，在尸检中发现了脂肪瘤。大的心脏脂肪瘤可导致并发症，如心室流出道阻塞，电紊乱,栓塞或心包积液。在诊断为RA脂肪瘤的26例患者中，有11例（42％）报告了右心室流出道阻塞。一般来说,心房脂肪瘤可以有各种大小。最有用的成像技巧是经胸超声心动图。心脏脂肪瘤的准确诊断和评估依赖于多模态成像方法，包括心脏磁共振.手术是治疗的选择，但是必须考虑风险收益比，必须考虑到共同决策。本综述数据显示，25例患者中有23例（92％）接受了手术。在这些患者中,2021年,23人中只有1人接受了微创治疗.心脏脂肪瘤是罕见的实体，通常无症状，这可能发生在任何年龄。心脏肿瘤最有用的诊断方法是超声心动图，但是核磁共振也可以确定肿瘤的类型和特征。
