心脏粘液瘤外科治疗中的某些问题

我科完成７６例心脏粘液瘤的手术治疗。左房７０例，右房５例，右室１例。全部经超声心动诊断，但有假阳性２例，假阴性１例。因高热而取消手术者，突然死于脑栓塞。对顽固性心衰病人进行手术进行以后，术后死于低心排综合征。术中发生的副损伤为心房破裂，这是由来粘液瘤生长在房壁上，切除瘤蒂时造成的。

Some Questions in Surgical Treatment of Cardiac Myxoma

This paper reported operations on 76 cases of cardiac myxoma. Situs of these tumors were as follow: left atrium in 70 (including malignant in 1), right atrium in 5 and right ventricle in 1.All of these patients were diagnosed by echocardiography.2 cases of false positive were confirmed after operations. It was because of no reliability which was examined by M echocardiography and other which could not be distinguished between tumors and thrombus. One patient was false negative, Choice of the right moment in the aspect of surgical treatment was very important.The operation was canceled on one patient for that her temperature was very high, but she died at that night as a result of cerebral embolism. One case was not operated on owing to serious heart failure continuously and she died after one week, so we operated on another two cases who had serious heart failure, but they died from low cardiac output syndrome postoperation. As for incision on heart,we preferred to incise right atrium and interatrial septum rather than biatrial horizontal incision. For it was very favourite to seek the base of tumor and to explore all of the cardiac cavity. Atrial wall rupture could be happened owing to the tumor arised from atrial wall when the base of tumor was removed.