心内粘液瘤的外科治疗

Surgical Treatment of Intracardiac Myxomas

  • Abstract: This article presents an analysis of 9 cases of myxomas treated surgically, 7 in the left atrium, 1 in right and left atria and 1 in right ventricular outflow tract. Their clinical manifestations fall into 3 categories, namely systemic febrile reaction, embolization and mechanical obstruction of the atrioventricular valve or ventricular outflow tract. The authors pointed out the space occupying effect of the tumor and the obstruction of the orifices of the pulmonary veins by the tumor also play an important role in producing the clinical symptoms. By keeping all these points in mind and by the early employment of repeated ultrasonic echocardiography, it is possible to make an early diagnosis. Surgical treatment should be instituted as soon as the diagnosis is established. However, appropriate preoperative preparation should be carried out. Gentle manipulation during intracardiac exploration, cannulation and removal of the tumor is stressed. Radical removal of the tumor and thorough intracardiac lavage and aspiration of the air trapped inside of the heart are vitally important in preventing recurrence and embolism. History of embolization of the coronary and cerebral arteries should be taken into serious consideration in weighing the surgical risk and the prognosis after surgery. Details of the surgical techniques were discussed.

     

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