This is an automatically translated article.
The article was consulted with Dr. Nguyen Luong Tan - Head of Cardiology Department - Cardiovascular Center - Vinmec Central Park International General Hospital.Myocardial tumor is a rare disease, including primary and secondary tumors metastasized from other organs. Primary tumors in the heart muscle are mostly benign tumors, but emergency surgery is required because of the risk of blockages that impede blood flow in the heart, causing sudden death.
1.Myocardial tumor overview
As with other organs, tumor formation in the myocardium can also occur, although it is rare but not unheard of. Myocardial tumors include primary and secondary tumors, and surgical treatment is indicated for primary tumors. Most of the tumors in the heart are benign, accounting for about 80%, of which, mucinous tumors are the most common benign tumors, accounting for about 40%. Myocardial mucinous tumor can occur at any age, including children, but the rate of infants and young children is very low, the disease is most common in the age group from 30-60 years old, the tumor location is common. especially in the left atrium up to 75%, right atrium about 23%, in the ventricle only 2%.
Bệnh nhân u cơ tim thường xuất hiện triệu chứng mệt mỏi, khó thở
When there is a tumor in the heart that will impede blood flow in the heart, a large tumor in the atrium can block the mitral or tricuspid valve openings, obstructing the flow of blood to the muscle. body and blood flow to the lungs. In addition, mucinous tumors are prone to sloughing because they are retained only by the pedicle of the tumor, so it is possible that pieces of tissue slough off, or the mucinous tumor breaks off, thereby moving into the bloodstream and these plaques can cause embolism. blockage in blood vessels throughout the body, leading to dangerous complications such as cerebral infarction, pulmonary embolism, myocardial infarction, blockage of arteries supplying intestines, kidneys, legs...
Because of complications dangerous, the risk of sudden death in people with heart muscle tumors, so surgical intervention is essential as soon as the heart muscle tumor is detected.
Primary tumors of the myocardium have about 10% of causes related to genetic factors. The other causes are unknown.
Cardiomyopathy may be discovered incidentally during cardiac examination or when complications develop.
Patients with cardiomyopathy may experience symptoms such as: Fatigue, shortness of breath on exertion, chest pain, possibly arrhythmia...
2.Treatment of cardiomyopathy
Tim bẩm sinh chống trỉ định với điều trị u cơ tim
The surgical removal of myocardium to treat myocardial tumor is an emergency performed when a primary myocardial tumor is detected.
2.1 Indications for myocardial tumor removal surgery
Myocardial resection is indicated in the following cases:
The patient has been diagnosed with primary myocardial tumor. Patients with one or more clinical and subclinical symptoms such as dyspnea, chest pain, regurgitation of heart valves, dilated heart chambers, pulmonary hypertension, pulmonary edema. 2.2 Contraindications to cardiomyopathy
Absolute contraindication in cases where the secondary cardiac tumor is a metastatic tumor from another place. In addition, there are some relative contraindications such as:
Fixed pulmonary hypertension Severe heart failure, severe liver and kidney failure Other complex congenital heart disease Active infection
2.3 Steps to perform surgery
Trước hôm phẫu thuật cần tắm hai lần nước pha với betadine
Preparation:
Performer: Is a doctor of combined specialties including surgery, anesthesia and artificial heart-lung machine operators. The patient is explained the issues related to the surgery, possible complications and risks. The previous afternoon, the patient was bathed twice with water mixed with betadine and changed all clean clothes. Brush the patient's chest with betadine soap before applying an antiseptic solution to the surgical area. Carrying out surgery
Patient: Lie on back, pillow under shoulder. Endotracheal anesthesia. Surgery: Open the midsternal line. Then suture the pericardium. Use intravenous heparin anticoagulant, establish extracorporeal circulation. Pumping solution for cardiac paralysis, cardiac arrest. Open the chamber of the heart corresponding to the location of the tumor. Tumor resection with tumor stalk and tumor attachment. Treatment of accompanying injuries (such as heart valve repair or heart valve replacement...) After the treatment is complete, close the heart chambers and restore circulation. Place drainage system, electrodes. Close sternum, fascia anatomically. Submit for histopathological examination of the obtained tumor to determine whether the tumor is benign or malignant.
3.Follow-up and complications after surgery
Khám sức khỏe định kỳ sau khi ra viện khoảng 6 tháng 1 lần để phòng ngừa tai biến
Post-operative monitoring:
After surgery, it is necessary to closely monitor the patient in the intensive care room for circulatory parameters such as: pulse, temperature, arterial blood pressure, electrocardiogram; drains drain status, urine output, ventilator parameters, and patient's mental status every 1 hour within 24 hours after surgery. The patient was monitored X-ray at the bed. Laboratory tests: Blood gases, electrolytes, blood count with hematocrit. Routine examination after discharge from hospital about once every 6 months. After 3 years, if there is no abnormality, it is considered cured. Possible complications after myocardectomy:
Bleeding through drainage Pneumothorax, hemothorax, arrhythmia, Cardiomyocardial tumour, is usually a benign tumor, but is caused by the tumor obstructing the outflow. in the heart, so the risk of dangerous complications, the patient can die suddenly if not treated surgically to remove the myocardium in time. Patients with cardiomyopathy may have genetic factors, so relatives of patients with cardiomyopathy should also have an echocardiogram to screen for the risk of the disease.
Patients with cardiomyopathy need early examination to diagnose disease and complications. Myocardial tumors can obstruct blood flow or move tumor fragments to the periphery, causing embolism. At Vinmec hospital, routine surgery for left atrial mucinous tumor is applied with high efficiency.
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