成人心脏乳头状弹力纤维瘤的临床和超声心动图特征

摘要

目的 探讨心脏乳头状弹力纤维瘤(CPF)的临床和超声心动图表现.方法 回顾性分析经手术病理证实的13例CPF患者的临床表现、超声心动图特征、手术方式及预后.结果 13例患者临床表现不具特异性,为不同程度胸闷、气短等症状.所有肿瘤均为单发,位于瓣膜9例(9/13,69.23％),其中主动脉瓣4例、二尖瓣3例、三尖瓣2例;位于心腔4例(4/13,30.77％),其中右心房2例、右心室1例、左心室1例.肿瘤最大径＞2 mm者8例,最大径≤2mm者5例.超声检出8例,未检出5例.8例接受肿瘤切除,5例接受瓣膜置换术.结论 CPF临床表现不特异,当肿瘤体积较小时,超声心动图常无法发现;心脏瓣膜为其常见部位,尤其是主动脉瓣.CPF预后良好.%Objective To explore the clinical features and echocardiographic characteristics of cardiac papillary fibroelastoma (CPF) in adults.Methods Clinical features,echocardiographic characteristics,surgical procedures and outcomes were retrospectively evaluated in 13 patients with CPF confirmed by pathology.Results The clinical features of CPF were atypical.The most common symptoms were chest distress and short breath.All the 13 patients were single lesions,9 cases (9/13,69.23％) involved the valves (4 on the aortic valve,3 on the mitral valve,2 on the tricuspid valve) and 4 cases (4/13,30.77％) involved the chambers (2 in the right atrium,1 in the right ventricle,1 in the left ventricle).The largest diameters of ＞2 mm were in 8 cases and ≤2 mm were in 5 cases.Eight cases were detected by echocardiographic examination and 5 cases were missed.Surgical excision was performed in 8 patients and prosthetic valve replacement was performed in 5 patients.Conclusion The clinical symptoms of CPF are variable.When the size of CPF is too small,echocardiography is difficult to detect.Most of CPFs originate on the valves,predominantly on the aortic valve.The prognosis of CPF is excellent.