Long-term follow-up of 82 patients after surgical excision of atrial myxomas.
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):183-8. doi: 10.1093/icvts/ivv125. Epub
2015 May 13.Long-term follow-up of 82 patients after surgical excision of atrial myxomas.1, 2, 2, 2, 2.1Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands .2Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands.AbstractOBJECTIVES: Literature reporting on large patient groups with the long-term follow-up is limited due to the low incidence of myxomas. This single-centre, retrospective study reports on the long-term follow-up (e.g. complications, recurrence and survival) of a substantial patient group operated for cardiac myxomas.METHODS: Patients were retrospectively selected from a prospectively obtained database comprising patients who had undergone cardiac surgery in the Catharina Hospital from 1990 onwards. Baseline characteristics and perioperative data were obtained from the database. In case of insufficient information, medical reports were analysed. The echocardiogram and clinical follow-up data were collected at outpatient clinics.RESULTS: Eighty-two patients were included, of which 48 were females with a mean age of 61.3 years (±13.8). The main presenting symptom was dyspnoea (29.3%), followed by chest pain (24.4%), palpitations (19.5%) and embolism (15.9%). Atrial fibrillation was the most f directly postoperative (22%) and at the long-term follow-up (26.3%). The follow-up was completed in 95.1%, with a mean echocardiographic follow-up time of 72 months and with a longest follow-up of almost 23 years. There were no myxoma recurrences. Thirteen patients (16.5%) deceased during the follow-up, with a mean time of 9 years after surgery.CONCLUSIONS: Myxomas carry the risk of severe complications. Surgical excision is the only option of treatment and gives excellent early and long-term results. Recurrence rates are low in case of non-hereditary myxomas, even in case of irradical excision. The echocardiographic follow-up therefore could be called into question.KEYWORDS: A C Long-term follow- R S SurvivalPMID:
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External link. Please review our .Myocardial protection strategy on the patients of valve disease combined with coronary artery disease in the cardiopulmonary bypass--《Chinese Journal of Extracorporeal Circulation》2010年04期
Myocardial protection strategy on the patients of valve disease combined with coronary artery disease in the cardiopulmonary bypass
Chen Xiang-zhou,Liu Mei,Peng Li,Hu Wei,Yang Zong-ying,Xiao Ying-bin,Chen Lin,Wang Xue-feng,Chen Jing-jin Department of Extracorporeal Circulation of Cardiovascular Surgery,Xin Qiao Hospital of the Third Military Medical University,Congqing 400037,China
OBJECTIVE This paper reported the myocardial protection strategy on 96 patients underwent valve surgery and coronary artery bypass grafting(CABG) with cardiopulmonary bypass(CPB) from January 2000 to December 2009 in the xinqiao hospital of the Third Military Medical University.METHODS During the CPB depressed the heart immediately to prevent excessive expansion of the heart,maintained adequate mean arterial pressure(MAP).Then we chose antegrade cardioplegia perfusion or retrograde coronary sinus cardioplegia perfusion or coronary arterial graft cardioplegia perfusion as the integrated way for myocardial protection with 4 parts blood to 1 part St.Thomas's.First,cold-blood(15-20℃) cardioplegia(potassium 22 mmol/L) was perfused.Then,cold-blood(10-15℃) cardioplegia(potassium 10 mmol/L) was perfused continuously.Warm blood(30-32℃) was administered for 3 to 5 minutes to the ascending aorta before unclamping the aorta.All patients suffered from complicated heart valve disease and coronary artery disease which included mitral valvuloplasty(MVP)+CABG(2 cases),mitral valve replacement(MVR)+CABG(18 cases),MVR+tricuspid valvuloplasty(TVP)+CABG(20 cases),aortic valve replacement(AVR)+CABG(24 cases),double valve replacement(DVR)+CABG(20 cases),DVR+TVP+CABG(8 cases),DVR+TVR+CABG(1 case),Bentall+CABG(3 cases).RESULTS The CPB time of patients was 101-360 minutesand the cross clamp time was 67-241 minutes.The cardiac spontaneous resuscitation was 60.4%,5 patients died and mortality was 5.21%.CONCLUSION Cold-blood with high potassium induction,cold-blood with low potassium continuous perfusion and terminal warm-blood perfusion provide good myocardial protection to the patients.It will increase the spontaneous resuscitation and the success rate of valve surgery and CABG.
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