cardiac masses - nt cardiovascular心脏肿瘤- nt心血管

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1、CARDIACMASSESNickTehrani,MDOutlineGeneralPrimaryCardiactumorsBenignMalignantSecondaryCardiacTumorsBenignMalignantQUIZTIMEGeneralNeoplasiaoftheheartorpericardiumismorelikelytobe:Secondary,thanPrimaryGeneralPrimarytumors<3/10,000autopsiesOver¾arebenignSecondary2

2、0-40xmorecommonPresentinupto20%ofpatientsdyingofmalignancyPrevalence:GeneralPresentation:EmbolizationSystemicPulmonary(lesscommon)ObstructionArrhythmiaTamponadeDirectcompressionofcoronaryarteryIntramyocardialConductiondisturbancesGlobaldysfunctionduetoinfiltra

3、tionWhatisthis?PotentialPitfallsReverberationartifactChangedepthandgainHiatalherniaFillstheRt.OrLt.AtriumDrinkPepsi…NormalAnatomicVariantsCristaterminalisNormalanatomicridgeEustatianvalveAttachestotheanteriorlipoftheIVCPosttransplantsuturelinesAllkindsoffunnym

4、assesIntraoperativeinversionoftheLtatrialappendageAnatomyCristaEustatianV.Whatisthis?OutlineGeneralPrimaryCardiactumorsBenignPrimaryCardiacTumorsBenignMyxomaPapillaryfibroelastomaFibromaLipomaRhabdomyomasBenignPrimaryCardiacTumorsThemostcommonprimarycardiactum

5、orintheAge>3575%intheLt.Atriumnearfossaovalis15%Rt.Atrium5-10%Lt.Ventricle5%multiplesitesWilldiscussfurtherMyxomas:BenignPrimaryCardiacTumorsGrosslyTypicallypedunculatedGelatinousconsistencyFriableHistologicallyCopiousmucopolysaccharidestromaScatteredsolitaryo

6、rclusteredpolygonalcells.…Myxomas:LeftatrialMyxomaBenignPrimaryCardiacTumorsExtracardiacmanifestationssuggestiveofCollagenVasculardz:FeverESRelevationAnemiaThrombocythemiaCirculatingautoantibodies…Myxomas:BenignPrimaryCardiacTumorsEtiologyofimmunologicmanifest

7、ations????TumornecrosisAnitimyocardialantibodytitersdeclinepostresection…Myxomas:BenignPrimaryCardiacTumorsHighpropensityforembolizationSurgicalresultsexcellentDecisiontooperate:Lt.versusRt.SidedtumorSx.AgeComorbiditiesManagementofMyxomas:BenignPrimaryCardiacT

8、umorsFamilialpatternofMyxomaswithautosomaldominantfeaturesAge<30Badactor…Anyguesses?CarneyComplexBenignPrimaryCardiacTumors…CarneyComplex:MultiplelentiginesandblueneviPeripheralmyx