心脏黏液瘤的诊断与手术治疗体会

R.M. Vitovskyi, V.V. Isaіenko, A.R. Vitovskyi, O.A. Pishchurin, V.V. Grabarchuk, O.V. Satmari
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引用次数: 0

摘要

目的是介绍心脏黏液瘤(CM)手术治疗的单中心经验和这种疾病的病程特点。材料和方法。在1969年1月1日至2023年1月1日期间,1015例患者接受了原发性心脏肿瘤手术。CM 902例(88.9%),其中左心房黏液瘤793例(87.9%)。CM患者年龄3 ~ 79岁(平均48.4±3.4岁),其中31 ~ 60岁653例(72.4%)。恶性肿瘤70例(6.9%)。结果。75例(8.3%)患者行瓣膜病变手术:15例(1.7%)患者行瓣膜假体手术,55例(6.1%)患者行修复手术(25例-二尖瓣矫正,30例-三尖瓣),均有良好的功能效果。328例(36.3%)和77例(8.5%)CM患者分别有III级和IV级NYHA功能衰竭,通常需要紧急手术。近年来CM手术治疗的住院死亡率为0.2%。结论。CM患者的最佳策略问题包括紧急诊断和手术干预,这保证了CM治疗的有效性,长期结果数据证实了这一点。患者20年生存率为79.7%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Experience of diagnosis and surgical treatment of cardiac myxomas
The aim – to present the one-centre experience of surgical treatment with сardiac myxomas (CM) and features of the course of this disease. Materials and methods. During the period from January 1, 1969 to January 1, 2023, 1015 patients were operated for primary heart tumors. CM were found in 902 (88.9 %) patients, of which 793 (87.9 %) cases were myxomas of the left atrium. The age of CM patients ranged from 3 to 79 years (on average 48.4 ± 3.4 years), of which 653 (72.4 %) were in the age from 31 to 60 years. Malignant tumors were observed in 70 (6.9 %) cases. Results. Surgery of valvular lesions was performed in 75 (8.3 %) patients: in 15 (1.7 %) cases – valve prosthesis, in 55 (6.1 %) cases – repair surgery (25 – mitral correction, 30 – tricuspid valves, respectively) with a positive functional effect. 328 (36.3 %) and 77 (8.5 %) patients with CM had heart failure of III and IV functional classes NYHA, respectively, which often required urgent surgery. Hospital mortality in recent years was 0.2 % in the surgical treatment of CM. Conclusions. The issues of optimal tactics for patients with CM consist of urgent diagnosis and surgical intervention, which ensures the effectiveness of treatment of CM, which is confirmed by the data of long-term results. Patient survival up to 20 years was 79.7 %.
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