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