نتايج جراحي بيماران مبتلا به ميكسوم قلبي: تجربه ده ساله

Outcomes of Surgical Resection of Cardiac Myxoma: A Ten-Year Experience

سابقه و هدف: ميكسوم قلب، شايع ترين تومور خوش خيم قلبي مي باشد. اين بيماري مي تواند بسياري از بيماري هاي قلبي يا سيستميك را تقليد كند. در اين جا تجربه ده ساله مركز قلب مازندران در مورد تظاهرات كلينيكي، عوارض حين و پس از جراحي، عود و مرگ و مير ميكسوم هاي قلبي گزارش مي شود. مواد و روش ها: اين مطالعه مشاهده اي بر روي 34 بيمار با تشخيص قبل از جراحي ميكسوم قلبي در يك دوره 10 ساله انجام شد (1395-1385). همه پرونده هاي پزشكي اين بيماران بررسي شد و داده ها در مورد تظاهرات كلينيكي، تست هاي تشخيصي، عوارض حين و پس از جراحي، عود و مرگ و مير ثبت شد. به علاوه، داده ها در مورد اندازه تومور، محل قرارگيري و اتصال و تشخيص هيستوپاتولوژيك، جمع آوري شد. بررسي هاي اكوكارديوگرافيك در انتهاي پيگيري انجام شد. استنتاج: اين بررسي، موارد كمي از عود ميكسوم را نشان داد. بنابراين، پيگيري طولاني مدت با اكوكارديوگرافي توصيه مي شود.

Background and purpose: Cardiac myxoma is the most common benign cardiac tumor. It can resemble many cardiovascular or systemic illnesses. This research presents a ten-year experience of Mazandaran heart center in clinical presentation, intra and post-operative complication, recurrence, and mortality of cardiac myxoma. Materials and methods: This observational study was performed in 34 patients with a preoperative diagnosis of myxoma over a 10-year period (2006-2016). The patients’ medical records were reviewed and some information including, clinical presentation, diagnostic tests, intra-operative and postoperative complications, recurrence, and mortality rate were recorded. Furthermore, data about tumor size, localization and attachment, and histopathological diagnosis were collected. Echocardiography was performed at the end of follow-up. Results: Histopathological studies confirmed diagnosis of myxoma in 30 patients mainly localized in left atrium that were attached to inter-atrial septum. The most common clinical presentation was dyspnea that was reported in 20 patients (58.8%). Systemic and central nervous system embolization were seen in 5.9% and 17.6%, respectively which were not associated with the size of myxoma. Two patients died during hospitalization. Also, two patients died during follow-up period due to other illnesses. One patient experienced recurrence. Conclusion: This study showed a low incidence of recurrence of cardiac myxoma. Therefore, long-term echocardiographic follow-up is recommended.