Minimal access approach for surgical management of cardiac tumors

Background. Following our experience with minimally invasive valve replacem ent operation, we utilized this technique for surgical management of cardia c tumors. Methods. Between April 1997 and September 1999, 5 consecutive patients with cardiac tumors underwent minimally invasive excision of the tumors. The pa tients were 4 women and 1 man with an age range of 32 to 50 years. The tumo r was located in the left atrium in 4 patients and the right atrium in 1 pa tient. The common presenting symptoms were dyspnea on exertion (100%), ches t pain (60%), palpitation (60%), and transient ischemic attack (20%). Diagn osis was established preoperatively by echocardiography only. Results. In 2 patients the approach was right parasternal and the subsequen t 3 patients had direct-access partial sternotomy. The myxoma was resected transseptally in all patients. There was no hospital mortality. One patient had postoperative embolic episode leading to left hemiparesis. Follow-up d id not reveal any complication related to this technique and all were in Ne w York Heart Association (NYHA) functional class I. Conclusions. Minimal access partial sternotomy is an effective approach tha t adheres to all the identified surgical principles in successful removal o f these tumors. The smaller incision does not compromise the efficacy or sa fety of the operation, reduces hospital stay, and has a good cosmetic resul t. (Ann Thorac Surg 2000;70:1077-9) (C) 2000 by The Society of Thoracic Sur geons.