Analysis Of Clinical Characteristics And Surgical Methods Of Cardiac Myxoma

ObjectiveThe clinical data of patients with cardiac myxoma diagnosed pathologically from January 2016 to December 20l8 in the Department of Cardiac surgery of Guangdong Provincial people's Hospital were analyzed retrospectively.The purpose of this study is to find out the clinical characteristics of cardiac myxoma,to achieve the clinical early diagnosis of cardiac myxoma,to find the risk factors related to vascular embolism events,to prevent the occurrence of embolization events in adxvance.and to focus on the treatment of cardiac mvxoma.To compare the effects of two kinds of surgical resection of myxoma and to explore the safety and efficacy of thoracoscopic minimally invasive left atrial myxoma resection.Methods1.Analysis of clinical characteristics of cardiac myxoma.From January 2016 to December 2018,179 patients with cardiac myxoma were treated surgically and finally diagnosed as cardiac myxoma in Guangdong Provincial people's Hospital.The clinical characteristics of the patients were statistically analyzed by SPSS software.2.Analysis of risk factors of vascular embolism in cardiac myxoma.From January 2016 to December 2018,179 patients with cardiac myxoma were treated surgically and finally diagnosed as cardiac myxoma in Guangdong Provincial people's Hospital.According to the occurrence of vascular embolism before operation,the patients were divided into embolization group and non-embolization group.The general situation,tumor characteristics and hematological examination of the two groups were statistically analyzed and compared by SPSS software.Logistic regression analysis was used to find out the risk factors of vascular embolism in cardiac myxoma.3.Comparison of clinical effects of thoracoscopic minimally invasive and median thoracotomy for left atrial myxoma.From January 2016 to December 2018,96 patients with left atrial myxoma were treated by left atrial myxoma resection and finally diagnosed as cardiac myxoma by pathological diagnosis in the Department of Cardiology,Guangdong Provincial people's Hospital.According to the different surgical methods,the patients were divided into minimally invasive group and median thoracotomy group.The general situation.surgical data?postoperative data and prognosis of the two groups were statistically analyzed and compared by SPSS software.Result1.Cardiac myxoma accounted for 87.7%of all cardiac tumors,63.1%of them were female,97.8%were single,and 86.0%were located in the left atrium.The clinical manifestations of the patients were obstruction(65.9%),vascular embolism(21.1%),asymptomatic(17.9%)and non-specific symptoms(5.6%).The recurrence rate after resection was 2.2%.2.The patients with vascular embolism events had better cardiac function classification;the proportion of patients with valvular heart disease was lower;echocardiography showed that the shape of the tumor was irregular,the tumor activity was high,the proportion of tumor access mode was higher,and the FIB level of hematological examination was higher.Stepwise Logistics regression analysis showed that high tumor activity and FIB level were independent risk factors for vascular embolism3.The blocking time and cardiopulmonary bypass time of patients with thoracoscopic minimally invasive left atrial myxoma resection were longer than those of patients with median thoracotomy and left atrial myxoma resection,and the intraoperative bleeding was less than that of patients with median thoracotomy and left atrial myxoma resection.The postoperative tracheal intubation time,indwelling drainage tube time,hospitalization time were shorter,and the satisfaction of incision healing was higher.All patients were followed up for 3?38 months.there was no death,no vascular embolism and no recurrence in patients undergoing thoracoscopic minimally invasive left atrial myxoma resection.ConclusionCardiac myxoma is a rare disease,but it has a high status in cardiac tumor diseases and has a certain recurrence rate.Common in middle-aged women,the most common part of the left atrium.Cardiac myxoma is mainly obstruction symptoms,embolism symptoms,systemic symptoms of the three major clinical manifestations.High FIB levels,echocardiography suggest irregular shape,high activity,in and out of the atrioventricular myxoma patients can not be ignored,even if the symptoms are mild,because such patients are more likely to develop embolism.Stepwise Logistics regression analysis showed that high tumor activity and FIB level were independent risk factors for vascular embolism.Thoracoscopic minimally invasive resection of left atrial myxoma is safe,feasible,effective and worth popularizing.