原发性心脏脂肪瘤非常罕见，其最佳治疗策略尚未形成共识。本研究回顾了20名患者超过20年的心脏脂肪瘤手术治疗情况。从2002年1月1日至2022年1月1日，在中国医学科学院和北京协和医学院故宫医院，共治疗了20例心脏脂肪瘤。对患者的临床资料和病理报告进行了回顾性分析，并进行了长达1至20年的随访。 这些心脏脂肪瘤位于右心房（RA）或上腔静脉（SVC）的七名患者中（六名患者的房间和一名患者的SVC），左心室的八名患者中（四名患者的左心室腔和四名患者的左心室心外膜和心肌），右心室的三名患者中（一个患者的右心室腔和两名患者的右心室心外膜和心肌），横向隔下的一名患者（5％），以及心包的一名患者（5％）。包括七名RA或SVC脂肪瘤患者在内，14名患者（70％）实现了完全切除。对于8名患有心室脂肪瘤的患者，切除不完全。术中没有发生死亡情况。对19名患者进行了长期随访（95％），其中有两名患者（10％）死亡。两位死亡的患者均因涉及心室切除不完全，术前恶性心律失常手术后仍然存在。 在不涉及心室的心脏脂肪瘤患者中，完全切除率很高，长期预后令人满意。对于患有心室脂肪瘤的患者，完全切除率较低，其中并发症，包括恶性心律失常，较为常见。完全切除失败和术后室性心律失常与术后死亡相关。 版权所有 © 2023 中国医师协会，由 Wolters Kluwer, Inc. 以 CC-BY-NC-ND 许可证生产。

Primary cardiac lipoma is very rare, and no consensus has been developed regarding its ideal treatment strategy. This study reviewed the surgical treatment of cardiac lipomas in 20 patients over 20 years.Twenty patients with cardiac lipomas were treated at Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College from January 1, 2002, to January 1, 2022. The patients' clinical data and pathological reports were retrospectively analyzed, and the follow-up with a range of 1 to 20 years was conducted.The cardiac lipomas were located in the right atrium (RA) or superior vena cava (SVC) in seven patients (35%) (atrium in six patiets and SVC in one patient), left ventricle in eight patients (40%) (left ventricular chamber in four patients and left ventricular subepicardium and myocardium in four patients), right ventricle in three patients (15%) (right ventricular chamber in one patient and right ventricular subepicardial layer and myocardium in two patients), subepicardial interventricular groove in one patient (5%), and pericardium in one patient (5%). Complete resection was achieved in 14 patients (70%), including seven patients with lipomas in the RA or SVC. Incomplete resection occurred in six patients (30%) with lipomas in the ventricles. No perioperative deaths occurred. Long-term follow-up was conducted for 19 patients (95%), including two (10%) who died. Both patients who died had lipomas incompletely resected due to ventricles involvement, and preoperative malignant arrhythmias persisted post-operatively.The complete resection rate was high, and the long-term prognosis was satisfactory in patients with cardiac lipomas that did not involve the ventricle. The complete resection rate was low in patients with cardiac lipomas in ventricles; and complications, including malignant arrhythmia, were common. Failure of complete resection and post-operative ventricular arrhythmia are correlated with post-operative mortality.Copyright © 2023 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.