SURGICAL-TREATMENT OF CARDIAC TUMORS - A 25-YEAR EXPERIENCE
SURGICAL-TREATMENT OF CARDIAC TUMORS - A 25-YEAR EXPERIENCE
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DOI：
10.1016/0003-4975(90)90310-3
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发表时间：
1990-04-01
影响因子：
4.6
通讯作者：
COOLEY, DA
中科院分区：
文献类型：
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作者：
MURPHY, MC;SWEENEY, MS;COOLEY, DA
自1964年至1989年，我们共施行心脏肿瘤手术133例。有58名男性和75名女性患者，年龄从3天到81岁不等; 101名为成人，32名为儿童（小于12岁）。原发性肿瘤（良性102例，恶性12例）114例，转移性肿瘤19例。症状包括充血性心力衰竭、心律失常、栓塞和胸痛。诊断是通过血管造影术，超声心动图，计算机断层扫描，磁共振成像。手术治疗包括从活检到完全切除（包括低温停循环和心脏自体移植）的技术，这取决于疾病的部位和参与的程度。总手术生存率为91%。12名患者早期死亡（手术后30天内），其余121名存活者中有110名（90.9%）获得随访（总随访患者年，572.8;平均随访时间，5.2年）。晚期死亡的20例患者中，15例患有恶性疾病。原发性心脏恶性肿瘤和转移性心脏恶性肿瘤患者的手术生存率分别为83%和68.4%，分别有3名和5名患者仍然存活。我们提倡积极的手术方法，特别是对良性肿瘤患者，他们可以期待一个很好的结果。对于患有恶性或转移性疾病的患者，如果采取积极的手术措施，也有可能缓解和治愈。
From 1964 to 1989, we performed operations on 133 patients with cardiac tumors. There were 58 male and 75 female patients ranging in age from three days to 81 years; 101 were adults, and 32 were children (less than 12 years of age). Primary tumors (102 benign and 12 malignant) were found in 114 patients and metastatic tumors in 19. Symptoms included congestive heart failure, arrhythmias, emboli, and chest pain. Diagnosis was accomplished through angiography, echocardiography, computed tomography, and magnetic resonance imaging. Operative treatment encompassed techniques ranging from biopsy to complete exision (including hypothermic circulatory arrest and cardiac autotransplantation) depending on the site of disease and the extent of involvement. Overall operative survival was 91%. Twelve patients died early (within 30 days of operation), and follow-up was obtained for 110 (90.9%) of the remaining 121 survivors (total patient-years of follow-up, 572.8; mean follow-up, 5.2 years). Of the 20 patients who died late, 15 had malignant disease. Operative survival for patients with primary cardiac malignancies and those with metastatic disease was 83% and 68.4%, respectively, with 3 and 5 patients, respectively, still living. We advocate an aggressive surgical approach, especially in patients with benign tumors, who can expect an excellent outcome. For patients with malignant or metastatic disease, palliation and cure are also possible if aggressive surgical actions are taken.