右心房粘液瘤的外科治疗

目的　探讨右心房粘液瘤的诊断和治疗经验。方法　回顾性分析自 1995年 10月至 2 0 0 1年 10月收治的19例右心房粘液瘤病例。术前均经彩色超声心动图确诊 ,均在体外循环下行粘液瘤摘除术 ,同期行三尖瓣成形术5例 ,三尖瓣机械瓣置换术 2例 ,房间隔缺损修补术 2例。结果　无围术期及手术死亡 ,随访 15例 ,时间 1个月～6年 ,心功能Ⅰ级 9例 ,Ⅱ级 3例 ,Ⅲ级 1例 ,1例死于非心脏方面的疾病 ,1例复发 ,再次手术 ,复发率 6 6 7% ,效果良好。结论　右心房粘液瘤一经确诊应尽快手术 ,手术效果满意 ,复发率低 ,心脏彩色超声心动图对诊断及术后随访有重要作用 ,应注意术后随访

Surgical treatment of right arial myxomas

Objective\ To review the clinical experience of diagnosis and surgical treatment for right atrial myxomas.Methods\ 19 patients with right atrial myxomas from Oct 1995 to Oct 2001 were analyzed retrospectively.All the diagnoses were confirmed by echocardiography before operation.All patients underwent excision of myxomas with the help of cardiopulmonary bypass.Associated procedures were tricuspid valvuloplasty in 15 cases,tricuspid valve replacement in 1 case and atrial septal defect repair in 2 cases.Results\ There was no hospital mortality.Excision of the tumor resulted in marked symptomatic improvement.The postoperative follow up interval ranged from one month to six years.In the 15 patients,9 were in functional class Ⅰ,3 were in classⅡ and 1 in class Ⅲ,1 died of noncardiac disease,1 patient had tumor recurrence and received reoperation.The rate of recurrence was 6.67%.Conclusion\ Surgical resection of right atrial myxomas is a safe and effective treatment with a low risk of recurrence and is imperative following the diagnosis.Echocardiography is the most useful diagnostic screening tool in the diagnosis and postoperative follow up for patients with right atrial myxomas.Close follow up is necessary.