右心粘液瘤的诊治

目的　探讨右心粘液瘤的诊治及疗效。方法　自 1984年 8月至 1999年 6月 ,16例右心粘液瘤病人接受外科治疗 ,术前超声心动图明确右房粘液瘤 11例 ,右室粘液瘤 5例 ,4例右房粘液瘤同时合并左房粘液瘤。均在体外循环下行粘液瘤摘除术 ,1例同时行三尖瓣置换术。结果　无围术期死亡 ,1例术后出现左心功能衰竭 ,运用左心辅助装置治疗后好转。随访 1个月到 15年 ,平均 4 8年。 1例术后13年粘液瘤原位复发再次手术治疗 ,复发率 6 .2 5 %。结论　右心粘液瘤一经确诊应立即手术 ,且效果好、安全。超声心动图对右心粘液瘤的诊断具有极其重要的作用。

Management of right hear myxomas

Objective: To review the experience of surgical treatment of right heart myxomas. Method: From Aug.1984 to Jun.1999, 16 patients with right heart myxomas underwent surgical treatment. The diagnosis was confirmed with echocardiography and histological study in all patients. The myxomas located in right atrium in 11 (4 associated with left atrial myxomas), and right ventricle in 5. All patients underwent excision of myxoma under cardiopulmonary bypass. Tricuspid valve replacement was performed in 1 patient. Result: There was no perioperative mortality. Acute left ventricular failure occurred in 1 patient after operation and temporary mechanical circulatory support was used. At a median of 4.8 years (ranged 1 month to 15 years ) after resection, there was one recurrence after 13 years and received reoperation. Conclusion: Patients with myxomas in the right heart should undergo operation as soon as possible. Surgical resection is the only effective therapeutic option. Echocardiography plays a very important role in the diagnosis for patients with myxomas in the right heart.