Yıl: 2014 Cilt: 22 Sayı: 3 Sayfa Aralığı: 526 - 533 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Kardiyak miksomalar: 27 yıllık cerrahi deneyim

Öz:
Amaç: Bu çalışmada merkezimizde yapılan cerrahi kardiyak miksoma rezeksiyonunun sonuçları bildirildi.Ça­lış­ma­pla­nı:­Ocak 1985 - Aralık 2012 tarihleri arasında miksoma tanısıyla ameliyat edilen 99 hasta (67 kadın, 32 erkek, ort. yaş 49.8±16 yıl; dağılım 5-76 yıl) retrospektif olarak incelendi. Ameliyat öncesi tanı transtorasik ekokardiyografi ile konuldu. Son takip vizitine kadar geçen ortalama süre 123.4±85.7 ay idi.Bul gu lar: Tüm hastalar median sternotomi ile ameliyat edildi. Tümörün kökeni 92 hastada sol atriyum olup, en sık yerleşim yeri 85 hastada interatriyal septumdu. Bir hasta hariç tüm hastalarda total rezeksiyon yapıldı. Kırk beş hastaya (%45.5) papiller miksoma, 54 hastaya (%54.5) solid miksoma tanısı konuldu. Embolik olay riski papiller tip miksomalarda, solid tipe kıyasla, anlamlı oranda yüksek bulundu (%44.4'e kıyasla %9.3, p<0.01). Erken mortalite %5 idi. Tek değişkenli analiz sonuçlarına göre ileri yaş (p=0.04), ameliyat öncesi atriyal fibrilasyon varlığı (p=0.02), periferik emboli (p=0.03) ve ameliyat sonrası inotropik destek ihtiyacı (p=0.008) erken mortalite için risk faktörleri olarak belirlendi. Beş, 10 ve 20 yıllık aktüeryal sağkalım oranları sırası ile %98, %94 ve %89 idi. Sağkalanlarda nüks oranı %1.2 olarak tespit edildi.So nuç: Kardiyak miksoma cerrahisi, düşük ameliyat riski taşımakla birlikte, mükemmel kısa ve uzun dönem sonuçlar ile ilişkilendirilir. Ancak, uzun dönemde düşük nüks riskine rağmen, hastalar yıllık ekokardiyografi ile takip edilmelidir.
Anahtar Kelime:

Konular: Anestezi Kalp ve Kalp Damar Sistemi Cerrahi

Cardiac myxomas: a 27-year surgical experience

Öz:
Background: In this study, we reported the outcomes of surgical resection of cardiac myxomas performed in our center. Methods: A retrospective review of 99 patients (67 females, 32 males, mean age 49.8±16 years; range 5 to 76 years) who were operated for myxoma between January 1985 and December 2012 was conducted. Preoperative diagnosis was established by transthoracic echocardiography. The mean time to the last follow-up visit was 123.4±85.7 months. Results: All patients were operated through median sternotomy. The site of origin of the tumor was left atrium in 92 patients and the most common implantion site was interatrial septum in 85 patients. A complete resection of the tumor was performed in all patients except one. Forty five patients (45.5%) were diagnosed with a papillary myxoma, while 54 patients (54.5%) were diagnosed with a solid myxoma. The risk of embolic events in papillary type of myxoma was significantly higher than the solid type (44.4% vs. 9.3%, p<0.01). Early mortality was 5%. Univariant analysis showed advanced age (p=0.04), preoperative presence of atrial fibrillation (p=0.02), peripheral embolism (p=0.03), and need for postoperative inotropic support (p=0.008) as the risk factors for early mortality. Actuarial survival rate was 98%, 94% and 89% at five, 10 and 20 years, respectively. The rate of recurrence was 1.2% in survivors. Conclusion: Surgical treatment of cardiac myxoma carries a low operative risk and is associated with excellent short and long-term results. However, despite low risk of recurrence in the long-term, the patients should be followed with annual echocardiography.
Anahtar Kelime:

Konular: Anestezi Kalp ve Kalp Damar Sistemi Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Taş s, tunçer e, Boyacioglu K, ANTAL DÖNMEZ A, BAKAL R, KAYALAR N, Tuncer M, YAKUT C (2014). Kardiyak miksomalar: 27 yıllık cerrahi deneyim. , 526 - 533.
Chicago Taş serpil,tunçer eylem,Boyacioglu Kamil,ANTAL DÖNMEZ Arzu,BAKAL Ruken Bengi,KAYALAR Nihan,Tuncer Mehmet Altug,YAKUT Cevat Kardiyak miksomalar: 27 yıllık cerrahi deneyim. (2014): 526 - 533.
MLA Taş serpil,tunçer eylem,Boyacioglu Kamil,ANTAL DÖNMEZ Arzu,BAKAL Ruken Bengi,KAYALAR Nihan,Tuncer Mehmet Altug,YAKUT Cevat Kardiyak miksomalar: 27 yıllık cerrahi deneyim. , 2014, ss.526 - 533.
AMA Taş s,tunçer e,Boyacioglu K,ANTAL DÖNMEZ A,BAKAL R,KAYALAR N,Tuncer M,YAKUT C Kardiyak miksomalar: 27 yıllık cerrahi deneyim. . 2014; 526 - 533.
Vancouver Taş s,tunçer e,Boyacioglu K,ANTAL DÖNMEZ A,BAKAL R,KAYALAR N,Tuncer M,YAKUT C Kardiyak miksomalar: 27 yıllık cerrahi deneyim. . 2014; 526 - 533.
IEEE Taş s,tunçer e,Boyacioglu K,ANTAL DÖNMEZ A,BAKAL R,KAYALAR N,Tuncer M,YAKUT C "Kardiyak miksomalar: 27 yıllık cerrahi deneyim." , ss.526 - 533, 2014.
ISNAD Taş, serpil vd. "Kardiyak miksomalar: 27 yıllık cerrahi deneyim". (2014), 526-533.
APA Taş s, tunçer e, Boyacioglu K, ANTAL DÖNMEZ A, BAKAL R, KAYALAR N, Tuncer M, YAKUT C (2014). Kardiyak miksomalar: 27 yıllık cerrahi deneyim. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 22(3), 526 - 533.
Chicago Taş serpil,tunçer eylem,Boyacioglu Kamil,ANTAL DÖNMEZ Arzu,BAKAL Ruken Bengi,KAYALAR Nihan,Tuncer Mehmet Altug,YAKUT Cevat Kardiyak miksomalar: 27 yıllık cerrahi deneyim. Türk Göğüs Kalp Damar Cerrahisi Dergisi 22, no.3 (2014): 526 - 533.
MLA Taş serpil,tunçer eylem,Boyacioglu Kamil,ANTAL DÖNMEZ Arzu,BAKAL Ruken Bengi,KAYALAR Nihan,Tuncer Mehmet Altug,YAKUT Cevat Kardiyak miksomalar: 27 yıllık cerrahi deneyim. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.22, no.3, 2014, ss.526 - 533.
AMA Taş s,tunçer e,Boyacioglu K,ANTAL DÖNMEZ A,BAKAL R,KAYALAR N,Tuncer M,YAKUT C Kardiyak miksomalar: 27 yıllık cerrahi deneyim. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2014; 22(3): 526 - 533.
Vancouver Taş s,tunçer e,Boyacioglu K,ANTAL DÖNMEZ A,BAKAL R,KAYALAR N,Tuncer M,YAKUT C Kardiyak miksomalar: 27 yıllık cerrahi deneyim. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2014; 22(3): 526 - 533.
IEEE Taş s,tunçer e,Boyacioglu K,ANTAL DÖNMEZ A,BAKAL R,KAYALAR N,Tuncer M,YAKUT C "Kardiyak miksomalar: 27 yıllık cerrahi deneyim." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 22, ss.526 - 533, 2014.
ISNAD Taş, serpil vd. "Kardiyak miksomalar: 27 yıllık cerrahi deneyim". Türk Göğüs Kalp Damar Cerrahisi Dergisi 22/3 (2014), 526-533.