Abstract：
BACKGROUND: Cardiac myxoma is the most common type of primary cardiac tumor, with the majority located in the atrial wall. The tumor is attached to valvular structures in a few cases, of which the pulmonary valve is the least affected. Pulmonary valve myxoma may have different clinical manifestations from the more common cardiac myxomas because of its vital position. A misdiagnosis of these types of cardiac myxoma may be detrimental to the care and well-being of patients. Therefore, this systematic review aims to define the clinical characteristics of pulmonary valve myxoma and how this differs from a more common cardiac myxoma.
METHODS: Employed literature was obtained from PubMed, ScienceDirect, Scopus, Springer, and ProQuest without a publication year limit on August 23, 2022. The keyword was \"pulmonary valve myxoma.\" Inclusion criteria were as follows: (1) case report or series, (2) available individual patient data, and (3) myxoma that is attached to pulmonary valve structures with no evidence of metastasis. Non-English language or nonhuman subject studies were excluded. Johanna Briggs Institute checklists were used for the risk of bias assessment. Data are presented descriptively.
RESULTS: This review included 9 case reports from 2237 articles. All cases show a low risk of bias. Pulmonary valve myxoma is dominated by males (5:4), and the patient\'s median age is 57 years with a bimodal distribution in pediatric and geriatric populations. The clinical manifestation of pulmonary valve myxoma is often unspecified or asymptomatic. However, systolic murmur in the pulmonary valve area is heard in 67% of cases. Echocardiography remains the diagnostic modality of choice in the majority of cases. Tumor attached to the pulmonary cusps or annulus and extended to adjacent tissues in all cases. Therefore, valve replacement or adjacent tissue reconstructions are required in 77% of cases. The recurrence and mortality are considerably high, with 33% and 22% cases, respectively.
CONCLUSIONS: Pulmonary valve myxoma is more common in males with a bimodal age distribution, and its outcomes seem worse than usual cardiac myxomas. Increasing awareness of its clinical symptoms, early diagnosis, and complete myxoma resection before the presence of congestive heart failure symptoms are important in achieving excellent outcomes. A firm embolization blockade is needed to prevent myxoma recurrence.
METHODS: Employed literature was obtained from PubMed, ScienceDirect, Scopus, Springer, and ProQuest without a publication year limit on August 23, 2022. The keyword was \"pulmonary valve myxoma.\" Inclusion criteria were as follows: (1) case report or series, (2) available individual patient data, and (3) myxoma that is attached to pulmonary valve structures with no evidence of metastasis. Non-English language or nonhuman subject studies were excluded. Johanna Briggs Institute checklists were used for the risk of bias assessment. Data are presented descriptively.
RESULTS: This review included 9 case reports from 2237 articles. All cases show a low risk of bias. Pulmonary valve myxoma is dominated by males (5:4), and the patient\'s median age is 57 years with a bimodal distribution in pediatric and geriatric populations. The clinical manifestation of pulmonary valve myxoma is often unspecified or asymptomatic. However, systolic murmur in the pulmonary valve area is heard in 67% of cases. Echocardiography remains the diagnostic modality of choice in the majority of cases. Tumor attached to the pulmonary cusps or annulus and extended to adjacent tissues in all cases. Therefore, valve replacement or adjacent tissue reconstructions are required in 77% of cases. The recurrence and mortality are considerably high, with 33% and 22% cases, respectively.
CONCLUSIONS: Pulmonary valve myxoma is more common in males with a bimodal age distribution, and its outcomes seem worse than usual cardiac myxomas. Increasing awareness of its clinical symptoms, early diagnosis, and complete myxoma resection before the presence of congestive heart failure symptoms are important in achieving excellent outcomes. A firm embolization blockade is needed to prevent myxoma recurrence.
摘要：
背景：心脏粘液瘤是最常见的原发性心脏肿瘤，大部分位于心房壁。在少数情况下，肿瘤附着在瓣膜结构上，其中肺动脉瓣受影响最小。肺动脉瓣粘液瘤可能由于其重要位置而具有与更常见的心脏粘液瘤不同的临床表现。这些类型的心脏粘液瘤的误诊可能不利于患者的护理和健康。因此,本系统综述旨在明确肺动脉瓣粘液瘤的临床特征,以及肺动脉瓣粘液瘤与更常见的心脏粘液瘤有何不同.
方法：使用的文献来自PubMed，ScienceDirect,Scopus,Springer,和ProQuest，2022年8月23日没有发布年份限制。关键词是“肺动脉瓣粘液瘤”。“纳入标准如下：(1)病例报告或系列，(2)可用的个体患者数据，和（3）粘液瘤，附着在肺动脉瓣结构上，没有转移的证据。非英语或非人类受试者研究被排除。JohannaBriggs研究所的检查表用于偏见风险评估。数据以描述性方式呈现。
结果：本综述包括2237篇文章中的9例病例报告。所有病例均显示低偏倚风险。肺动脉瓣粘液瘤以男性为主（5：4），患者的中位年龄为57岁，在儿科和老年人群中呈双峰分布。肺动脉瓣粘液瘤的临床表现通常未明确或无症状。然而,在67％的病例中听到肺动脉瓣区域的收缩期杂音。在大多数情况下，超声心动图仍然是选择的诊断方式。在所有情况下，肿瘤都附着在肺尖或肺环并延伸到邻近组织。因此,77%的病例需要进行瓣膜置换或邻近组织重建。复发率和死亡率相当高，33%和22%的病例，分别。
结论：肺动脉瓣粘液瘤在具有双峰年龄分布的男性中更为常见，其结果似乎比通常的心脏粘液瘤更糟糕。提高对其临床症状的认识，早期诊断,在出现充血性心力衰竭症状之前完成粘液瘤切除术对于取得优异的预后很重要.需要牢固的栓塞阻滞以防止粘液瘤复发。
方法：使用的文献来自PubMed，ScienceDirect,Scopus,Springer,和ProQuest，2022年8月23日没有发布年份限制。关键词是“肺动脉瓣粘液瘤”。“纳入标准如下：(1)病例报告或系列，(2)可用的个体患者数据，和（3）粘液瘤，附着在肺动脉瓣结构上，没有转移的证据。非英语或非人类受试者研究被排除。JohannaBriggs研究所的检查表用于偏见风险评估。数据以描述性方式呈现。
结果：本综述包括2237篇文章中的9例病例报告。所有病例均显示低偏倚风险。肺动脉瓣粘液瘤以男性为主（5：4），患者的中位年龄为57岁，在儿科和老年人群中呈双峰分布。肺动脉瓣粘液瘤的临床表现通常未明确或无症状。然而,在67％的病例中听到肺动脉瓣区域的收缩期杂音。在大多数情况下，超声心动图仍然是选择的诊断方式。在所有情况下，肿瘤都附着在肺尖或肺环并延伸到邻近组织。因此,77%的病例需要进行瓣膜置换或邻近组织重建。复发率和死亡率相当高，33%和22%的病例，分别。
结论：肺动脉瓣粘液瘤在具有双峰年龄分布的男性中更为常见，其结果似乎比通常的心脏粘液瘤更糟糕。提高对其临床症状的认识，早期诊断,在出现充血性心力衰竭症状之前完成粘液瘤切除术对于取得优异的预后很重要.需要牢固的栓塞阻滞以防止粘液瘤复发。
