PMID- 28723765
OWN - NLM
STAT- MEDLINE
DCOM- 20170728
LR  - 20210109
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 29
DP  - 2017 Jul
TI  - Perioperative management of intracardiac leiomyomatosis: An observational cohort 
      study.
PG  - e7522
LID - 10.1097/MD.0000000000007522 [doi]
LID - e7522
AB  - Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor 
      extends into the right heart chambers through inferior vena cava. The best 
      surgical approach still remains unclear.We present a retrospective cohort of 36 
      patients diagnosed with ICLM in Peking Union Medical College Hospital between 
      2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical 
      manifestations were various, including shortness of breath, chest tightness, 
      edema of the lower extremities, palpitations, syncope, etc. Cardiac function of 
      30 patients (80%) remained mildly influenced, classified as New York Heart 
      Association (NYHA) I-II. After careful preoperative evaluation, 19 patients 
      underwent 1-stage operation while the other 17 patients underwent 2-stage 
      operations. The original surgical plans were changed in 5 patients (14%) due to 
      intraoperative transesophageal echocardiography (TEE) monitoring, with the tumor 
      directly extracted through abdominal approach or right atrium without 
      cardiopulmonary bypass and/or deep hypothermic circulatory arrest. Complete 
      resection was achieved in 32 patients (89%). Despite increased volume of blood 
      loss (P < .05), patients undergoing 1-stage operation had significantly shorter 
      operation time, anesthesia time as well as hospital length of stay (P < .05), 
      compared with 2-stage operations. The postoperative complication rates were not 
      different between the 2 groups (P = .684). During mean follow-up time of 36.1 
      months, recurrence occurred in 7 patients (23%) but all are survived.Precise and 
      full-scale preoperative evaluation of both the tumor anatomy and the patient's 
      tolerability to the surgery should be performed. TEE plays a crucial role in 
      guidance of surgical decision making, and 1-stage extraction of tumor through 
      either abdominal approach or right atrium may be possible.
FAU - Xu, Jiaying
AU  - Xu J
AD  - Department of Anesthesiology Department of Cardiac Surgery, Chinese Academy of 
      Medical Sciences/Peking Union Medical College Hospital Department of 
      Anesthesiology, Peking University International Hospital, Beijing, P.R. China.
FAU - Wei, Min
AU  - Wei M
FAU - Miao, Qi
AU  - Miao Q
FAU - Zhu, Bin
AU  - Zhu B
FAU - Yu, Chunhua
AU  - Yu C
FAU - Huang, Yuguang
AU  - Huang Y
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Adult
MH  - Cardiac Surgical Procedures
MH  - Echocardiography, Transesophageal
MH  - Follow-Up Studies
MH  - Heart Neoplasms/diagnostic imaging/pathology/*therapy
MH  - Humans
MH  - Leiomyomatosis/diagnostic imaging/pathology/*therapy
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local
MH  - *Preoperative Care
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Treatment Outcome
PMC - PMC5521905
COIS- The authors have no funding and conflicts of interest to disclose.
EDAT- 2017/07/21 06:00
MHDA- 2017/07/29 06:00
PMCR- 2017/07/21
CRDT- 2017/07/21 06:00
PHST- 2017/07/21 06:00 [entrez]
PHST- 2017/07/21 06:00 [pubmed]
PHST- 2017/07/29 06:00 [medline]
PHST- 2017/07/21 00:00 [pmc-release]
AID - 00005792-201707210-00030 [pii]
AID - MD-D-16-06280 [pii]
AID - 10.1097/MD.0000000000007522 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(29):e7522. doi: 10.1097/MD.0000000000007522.