Clinical Analysis Of 26 Cases Of Surgical Treatment Of Atrial Myxoma

Objective:By retrospective analysis of the case data of patients with cardiac myxoma treated by surgery,the characteristics of the disease and the effect of surgical treatment were analyzed,and the successful experience and lessons of failure were summarized,so as to provide reference and help for further improving the diagnosis and treatment of cardiac myxoma.Methods:By retrospectively analyzing the case data of patients with cardiac myxoma who underwent surgical treatment in cardiothoracic surgery of the Second Hospital of Shanxi Medical University from May 2010 to January 2020,summarized the basic disease characteristics,clinical manifestations and surgical effects of cardiac myxoma As well as long-term symptom relief,tumor recurrence and metastasis,survival,and cardiac function grading before and after surgery,guide the clinical diagnosis and treatment of cardiac myxoma.Results:Of the 26 cardiac myxoma cases,7 were male and 19 were female,with a male to female ratio of 1: 2.7,with an average age of(53.58 ± 9.31)years.Among all cases,26.92% had anemia,30.77% had hypertension,and had a combination The tremor was 11.54%,the breast disease was 7.69%(mucinous cancer,one case of undetermined breast tumor),and the previous history of cerebral infarction was 19.23%.The clinical manifestations were 11.54% asymptomatic,19.23% of new peripheral vascular embolism symptoms,and69.23% of hemodynamic obstruction-related symptoms(including shortness of breath,palpitations,chest pain or intermittent chest pain,fatigue,syncope).61.54% of obvious heart murmurs can be heard on heart auscultation.Most heart murmurs change with body position.Among them,the murmur is located in the apex of 56.25%.Cardiac ultrasonography indicated that the left atrium was a single atrial myxoma,and the average maximum diameter of the tumor was(55.83 mm ± 14.87mm);the tumor pedicles were located in the atrial septum;11 cases of tumors that could penetrate the mitral valve during diastole(42.31%),4 cases(15.38%)entered the left ventricle.Twenty-six patients underwent medial thoracotomy for myxoma under general anesthesia and cardiopulmonary bypass.Combined with the patient's individual situation,5 patients underwent tricuspid valvuloplasty;2 patients underwent mitral valve + tricuspid valvuloplasty;and 1 patient underwent left breast tumor resection.After operation,1 case of hyponatremia,1 case of bilateral pleural effusion,and 1 case of pericardial tamponade.The average operation time was(230.41 ± 77.70)min,the average cardiopulmonary bypass transfer time was(65.58 ± 30.43)min,and the average blocking time was(43.00 ± 20.64)min.During the operation,18 cases of automatic cardiac rebound after opening the aorta accounted for 69.23%,and 90% of the 10 cases of myxoma surgery in the past 3 years.The follow-up period was 2 months to 117 months.Three cases were lost to follow-up.Except for one case of chest tightness after occasional fatigue and three cases of asymptomatic patients,the remaining 19 cases all complained of symptom relief before surgery.According to the NYHA cardiac function classification,the follow-up cardiac function classification was performed on the follow-up subjects.Compared with the preoperative cardiac function classification,19 patients had the same or improved cardiac function classification before surgery,accounting for 73.08%.None of the successful follow-up cases showed tumor recurrence and metastasis.Conclusion:1.Cardiac myxoma mostly occurs in the left atrium,with a male to female ratio of 1:2.7.2.The clinical manifestations of cardiac myxoma are diverse,but the most common manifestations are hemodynamic changes and peripheral vascular embolism.3.Satisfactory results of surgical treatment,good long-term prognosis.