深低温停循环下双房黏液瘤合并大面积双侧肺肿瘤栓塞的手术切除：一例病例报告
Surgical Resection of Biatrial Myxoma Complicated by Massive Bilateral Pulmonary Tumor Embolism Under Deep Hypothermic Circulatory Arrest: A Case Report.
摘要(中文译文)
原发性心脏黏液瘤是最常见的良性心脏肿瘤，通常起源于左心房。双心房黏液瘤极为罕见，其合并双侧大面积肺动脉肿瘤栓塞则更为少见。我们报告一例32岁女性患者，表现为严重呼吸困难和低氧血症。超声心动图和增强计算机断层扫描显示右心房内一巨大球形肿瘤、左心房内一条带状肿瘤，以及广泛肿瘤栓子阻塞双侧肺动脉主干及外周分支。双心房肿瘤连同房间隔整块切除，肺动脉肿瘤栓子在深低温停循环下予以清除。组织病理学检查证实所有标本均为黏液瘤。术后患者呼吸道症状缓解，估测肺动脉收缩压由90 mmHg降至50 mmHg，室内空气下血氧饱和度由88%提高至93%。尽管术后三个月随访计算机断层扫描显示左肺动脉内残留肿瘤，但患者术后六个月随访时在华法林抗凝治疗下仍无症状。本病例突出了双心房黏液瘤合并双侧大面积肺动脉肿瘤栓塞的罕见表现，其中心内血流动力学可能促成了肿瘤形态的差异，并证明了深低温停循环在复杂肺动脉取栓术中的应用价值。
Abstract
Primary cardiac myxomas are the most common benign cardiac tumors and typically originate in the left atrium. Biatrial myxomas are extremely rare, and their association with massive bilateral pulmonary tumor embolism is even more uncommon. We report the case of a 32-year-old woman who presented with severe dyspnea and hypoxemia. Echocardiography and contrast-enhanced computed tomography revealed a large spherical tumor in the right atrium, a band-like tumor in the left atrium, and extensive tumor emboli obstructing the bilateral main and peripheral pulmonary arteries. The biatrial tumors were resected en bloc with the interatrial septum, and the pulmonary artery tumor emboli were removed under deep hypothermic circulatory arrest. Histopathological examination confirmed that all specimens were myxomas. Postoperatively, the patient's respiratory symptoms resolved, her estimated pulmonary artery systolic pressure decreased from 90 mmHg to 50 mmHg, and her oxygen saturation improved from 88% to 93% on room air. Although follow-up computed tomography performed three months after surgery demonstrated a residual tumor in the left pulmonary artery, the patient remained asymptomatic under warfarin anticoagulation therapy at the six-month postoperative follow-up. This case highlights a rare presentation of biatrial myxoma with massive bilateral pulmonary tumor embolism, in which intracardiac flow dynamics may have contributed to the distinct tumor morphologies, and demonstrates the utility of deep hypothermic circulatory arrest for complex pulmonary embolectomy.
如何引用
AMA
Kazuyuki Ishibashi, Mamika Motokawa, Mohammad Moniruzzaman, Aslam Ahmed, Shariful Islam. Surgical Resection of Biatrial Myxoma Complicated by Massive Bilateral Pulmonary Tumor Embolism Under Deep Hypothermic Circulatory Arrest: A Case Report.. Cureus. 2026; doi:10.7759/cureus.110901.
APA
Kazuyuki Ishibashi, Mamika Motokawa, Mohammad Moniruzzaman, Aslam Ahmed, Shariful Islam (2026). Surgical Resection of Biatrial Myxoma Complicated by Massive Bilateral Pulmonary Tumor Embolism Under Deep Hypothermic Circulatory Arrest: A Case Report.. Cureus. https://doi.org/10.7759/cureus.110901
GB/T 7714
Kazuyuki Ishibashi, Mamika Motokawa, Mohammad Moniruzzaman, Aslam Ahmed, Shariful Islam. Surgical Resection of Biatrial Myxoma Complicated by Massive Bilateral Pulmonary Tumor Embolism Under Deep Hypothermic Circulatory Arrest: A Case Report.[J]. Cureus, 2026 doi:10.7759/cureus.110901.
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