心脏脂肪瘤的临床特征及外科治疗结果

目的分析心脏脂肪瘤的临床特征和外科治疗结果。方法回顾性分析我院2002～2012年间582例行外科手术的心脏肿瘤病人的临床资料。其中,共10例心脏脂肪瘤病人接受外科手术切除,女5例,男5例;年龄7～62岁,中位年龄46. 5岁。7例在体外循环下手术,3例在非体外循环下手术。合并房间隔缺损1例,同期外科手术修补。结果心脏脂肪瘤占总体心脏肿瘤的1. 72%。老年病人占所有脂肪瘤病人的10%(1/10)。10例中完全切除8例(80%),部分切除2例(20%),无早期死亡。老年心脏脂肪瘤病人的手术体外循环时间、主动脉阻断时间长于非老年病人;术后呼吸机辅助时间、ICU时间及术后住院时间长于非老年病人。9例(9/10,90. 00%)病人随访72～193个月,平均(126. 10±44. 46)个月,无远期死亡,心功能(NYHA分级)Ⅰ级或Ⅱ级。结论本组心脏脂肪瘤占总体心脏肿瘤的1. 72%。老年病人占脂肪瘤病人的10%。老年心脏脂肪瘤病人的手术时间及手术后恢复时间长于非老年病人,外科治疗远期结果良好。

Clinical features and long-term surgical outcome of cardiac lipomas

Objective To analyze the clinical features and long-term surgical outcome of cardiac lipomas.Methods A total of 582 patients receiving surgical resection of cardiac tumors in our center from January 2002 to December 2012 were retrospectively analyzed.A total of 10 patients with cardiac lipomas underwent surgical resection.There were 5 male and 5 female.The median age was 46.5 years(ranging from 7 to 62 years old).The operations were performed under cardiopulmonary bypass in 7 patients,and non-cardiopulmonary bypass in 3 patients.Associated cardiac lesions included congenital atrial septal defect in 1 patient,which was corrected at the same time.Results There was no early death after operation.All the patients recovered well unevenfully.The incidence rate of cardiac lipomas among total cardiac tumors was 1.72%.The rate of elderly patients in cardiac lipomas was 10%.The aortic cross-clamp time,cardiopulmonary bypass time,time of mechanical ventilation support,time in ICU,and the length of postoperative hospital stay in the elderly patient were longer than that those in non-elderly patients.Nine patients(90.00%)were followed up from 72 to 193 months(126.10±44.46months).There was no late death.These patients presented with the New York Heart Association(NYHA)functional classesⅠandⅡ.Conclusions The incidence of cardiac lipomas among total cardiac tumors is 1.72%,and the elderly occupy 10%.The operative time and postoperative recovery time in elderly patient are longer than those of non-elderly patients.Surgical resection of cardiac lipomas shows good long-term outcome.