[Clinical analysis of intravenous-cardiac leiomyomatosis]

Objective: To summarize the clinical characteristics, treatment and prognosis of patients with right intravenous-cardiac leiomyomatosis, and provide references for clinical diagnosis and management. Methods: The clinical data of 22 patients who were admitted to Department of Cardiac Surgery in Beijing Anzhen Hospital from November 2009 to July 2019 were retrospectively reviewed. The long-term prognosis of the patients was also evaluated. Results: All patients were women, with an age of (48.1±6.3) years. The clinical manifestations of patients lacked specificity. Among them, 14 patients had a history of uterine leiomyoma, 12 had hysterectomy, and 5 had abortions. Twenty patients underwent tumor resection. One-stage operation was performed in 15 cases, while staging surgery was performed in 5 cases. Ten cases underwent tumor resection under cardiopulmonary bypass. One case underwent a tricuspid valve annuloplasty at the same time. There was no death early in postoperative period. Early complications included deep venous thrombosis (2 cases), type Ⅱ atrioventricular block (1 case), pleural effusion (1 case) and incision infection (1 case). In the long-term follow-up (3 years), one case died of tumor recurrence-associated circulatory failure. Among the rest of the patients, the quality of life was satisfying, and cardiac function was between grade Ⅰ and Ⅱ, with no recurrence or metastasis. Conclusions: Patients with intravenous-cardiac leiomyomatosis are lack of specific manifestations. Early diagnosis is crucial for the treatment of this disease. Tumor resection is an effective treatment, which can improve the quality of life and long-term survival of patients.