VIDEO-ASSISTED CARDIAC-SURGERY FOR INTRACARDIAC TUMORS

Objective: To present our experience in surgical excision of intracard iac tumors in three patients using video-assisted cardiac surgical tec hniques, Methods: Three patients received emergency video-assisted car diac surgery for excision of right atrial or left atrial tumors. These surgeries were performed through right anterior submammary minithorac otomies and guided by video-assisted endoscopic techniques by projecte d images on a video monitor while under femoro-femoral cardiopulmonary bypass. The myocardium was protected by continuous coronary perfusion with fibrillatory arrest. Conventional instruments were used. Results : All but one of the tumors were excised completely. The bypass time w as 88-148 min. The operation time was 3.5-4.4 h. There were no operati ve deaths. Pathological examination of the tumors showed left atrial m yxoma, metastatic left atrial choriocarcinoma, and right atrial lympho ma. One patient died from noncardiac origin 5 weeks after discharge. F ollow-up was completed with the two survivors. Transthoracic echocardi ographic examination showed good ventricular Function without any resi dual tumors. They were both in New York Heart Association functional c lass I or II. They were satisfied with the cosmetic healing of their i ncisions. Conclusion: Video-assisted cardiac surgery is technically fe asible and can be performed in surgical excision of intracardiac turne rs. (C) 1998 Elsevier Science B.V. All rights reserved.