左心房粘液瘤24例的外科治疗

自1979年9月至1987年3月手术治疗左房粘液瘤24例,死亡2例。均经超声心动图检查确诊。心脏粘液瘤虽属良性肿瘤,但也可恶性变。肿瘤碎块脱落,引起肺循环或体循环栓塞或猝死,一旦确诊,就应尽早手术。作者认为,经右房切口切除左房粘液瘤较为方便并利于探查右房,排除粘液瘤穿越间隔。24例全部切除卵圆窝处房间隔,18例直接缝合,6例用心包补片修补房间隔。平均随访27个月,效果满意,无复发。

Surgical Treatment of 24 Cases of Left Atrial Myxoma

From September 1979 to March 1987, we have performed operations on 24 cases of left atrial myxoma, of them 2 cases died. The preoperative diagnosis was established by echocardiography in all cases. Cardiac myxoma is benign tumour, but it may become malignant. The pieces of the tumour can cause embolism in pulmonary and systemic circulation or sudden death. Once the diagnosis is made, the patient should be operated on as soon as possible. The right atrial incision suitable to excision of left atrial myxoma avails examining the right atrium to see whether there is myxoma in interatrial septum. Tumours were excised together with the interatrial septum in the fossa ovalis in 24 cases. Direct suture of the de-fects was undertaken in 18 cases and pericardiac patch was used in 6 cases. 22 patients were followed up for average 27 months. The effect was satisfa-ctory and there was no recurrence.