背景:原发性心脏肿瘤很少见,心脏粘液瘤(CM)占这些肿瘤的大部分。文献中的大多数报告是病例报告。本研究总结了我们近12年来外科治疗CM的临床经验。
方法:我们回顾性分析了23例CM患儿的临床资料(8例男孩,15名女孩;平均年龄:8.92个月,范围:2年5个月-12年9个月;体重:11-45公斤,中位体重:28.21公斤)在过去的12年中被我们医院收治,并对其临床表现和手术方法进行统计学分析。
结果:23例行体外循环(CPB)下粘液瘤切除术。随访期为0.2至12.6年(平均:7.2年)。无法追踪到两个病人,随访完成率为91.30%。1例(4.35%)在手术后早期死于心肌梗死,连续心输出量低。没有脑栓塞,急性心力衰竭,房室传导阻滞等相关并发症19例。1例脑梗死合并右侧偏瘫患者经康复治疗后恢复良好。19例CM无复发,所有患者术后均恢复。一名患者在手术后5年复发,第二次手术后未见肿瘤复发。在20名长期幸存者中,13例(65.00%)为NYHAI级患者,7例(35.00%)为NYHAII级患者。
结论:尽管儿童中的CM很少见,可引起脑梗塞等多器官栓塞。一旦找到CM并尽快删除,它可以减少严重的并发症。如果完全切除是可能的,手术提供了更好的缓解。术后应注意超声心动图的随访。
Primary cardiac tumors are rare, and cardiac myxoma (CM) accounts for the majority of these tumors. Most of the reports in the literature are case reports. This study summarizes our clinical experience in the surgical treatment of CM over the past 12 years.
We retrospectively analyzed the clinical data of 23 children with CM(8 boys, 15 girls; median age: 8.92 months, range: 2 years 5 months-12 years 9 months; body weight: 11-45 kg, median body weight: 28.21 kg) admitted to our hospital in the previous 12 years, and we statistically analyzed their clinical manifestations and surgical methods.
23 cases underwent myxoma excision under cardiopulmonary bypass(CPB). The follow-up period was 0.2 to 12.6 years (mean:7.2 years). Two patients could not be traced, and the follow-up completion rate was 91.30%. One patient (4.35%) died of myocardial infarction early after surgery with low continuous cardiac output. There were no cerebral embolism, acute heart failure, atrioventricular block and other related complications in 19 cases. A patient with cerebral infarction complicated with right hemiplegia recovered well after rehabilitation treatment. There was no recurrence of CM in 19 cases and all patients recovered after surgery. One patient relapsed 5 years after surgery, and no tumor recurrence was observed after the second surgery. Among the 20 long-term survivors, 13 (65.00%) were NYHA Class I patients and 7(35.00%) were NYHA Class II patients.
Although CM in children is rare, it may cause cerebral infarction and other multi-organ embolism. Once CM is found and removed as soon as possible, it can reduce serious complications. If the complete resection is possible, surgery provides better palliation. Follow-up echocardiographic should be paid attention to after surgery.