VIDEO-ASSISTED MINIMAL ACCESS IN EXCISION OF LEFT ATRIAL-MYXOMA

Background. Minimal access surgery with video-assisted endoscopy has b een applied to the correction of intracardiac lesions. We report our e xperience using this technique in surgical excision of left atrial myx oma in 3 patients. Methods. From November 1995 to March 1997, 3 female patients, ages 45 to 80 years (mean, 62.7 years), received emergency operations for excision of left atrial myxoma. These operations were p erformed through a right anterior submammary minithoracotomy or right parasternal incision with the assistance of endoscopy during femoro-fe moral cardiopulmonary bypass. The myocardium was protected by continuo us coronary perfusion with fibrillatory arrest or cardioplegic arrest with aortic cross, clamping. Results. All the tumors were excised comp letely through the right atrial approach. The bypass time was 92 to 14 8 minutes (mean, 111 minutes). The operation time was 3.2 to 4.4 hours (mean, 3.7 hours). There were no hospital deaths. Follow-up, which ra nged from 6 to 19 months (mean, 10.5 months), was complete in all pati ents. Transthoracic echocardiographic examination showed good ventricu lar function without any residual tumors. Patients were found to be in New York Heart Association functional class I or II. They were satisf ied with the good cosmetic healing of the incision. Conclusions. Our e xperience demonstrates that minimal access surgery is a technically fe asible, safe, and effective procedure in surgical excision of left atr ial myxoma. (Ann Thorac Surg 1998;66:1301-5) (C) 1998 by The Society o f Thoracic Surgeons