Clinical Outcomes of Left Atrial Myxoma Resection via Right Anterolateral Minithoracotomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUHong-duan , LIXin ,  YUFeng-xu , DENGMing-bin

Department of Cardiothoracic Surgery, Affiliated Hospital of Luzhou Medical College, Luzhou 646000, Sichuan, P. R. China;

Corresponding author：

YUFeng-xu, Email: yuluchuan@163.com

Keywords：

Minimally invasive surgery; Right anterolateral minithoracotomy; Cardiac myxoma; Cardiopulmonary bypass

DOI：

10.7507/1007-4848.20150011

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate clinical outcomes and safety of minimally invasive left atrial myxoma (LAM) resection via right anterolateral minithoracotomy (ALMT). Methods Clinical data of 9 patients who underwent minimally invasive LAM resection via right ALMT in the Affiliated Hospital of Luzhou Medical College from January 2011 to October 2013 were retrospectively analyzed. There were 2 male and 7 female patients with their age of 37-62 (51±9) years. The operation was performed through a small (4-6 cm) right ALMT incision. Femoral artery and vein and superior vein were cannulated to establish cardiopulmonary bypass (CPB). Transthoracic clamp was used for ascending aortic clamping. Antegrade cold blood cardioplegia was infused for myocardial protection. LAM was resected through right atriotomy trans-septal approach. Results All the operations were successfully performed without in-hospital death. Operation time was 210-310(260±33) minutes, aortic cross-clamping time was 23-50(37±9) minutes, CPB time was 60-87(71±9) minutes, postoperative mechanical ventilation time was 6-14(9.0±2.5) hours, and length of ICU stay was 17-26(20±3) hours. Postoperative mediastinum drainage was 100-650(376±190) ml. Mean length of right ALMT was 4.5-6.0 (5.3±0.6) cm. All the patients were followed up for 1 to 30 months,and echocardiography showed no LAM recurrence. Conclusion Minimally invasive LAM resection via right ALMT is safe and feasible with satisfactory clinical outcomes.

Citation： LIUHong-duan, LIXin, YUFeng-xu, DENGMing-bin. Clinical Outcomes of Left Atrial Myxoma Resection via Right Anterolateral Minithoracotomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(1): 36-38. doi: 10.7507/1007-4848.20150011 Copy

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12.	师恩祎, 谷天祥, 喻磊, 等. 微创与常规二尖瓣成形和置换术治疗单纯二尖瓣病变患者的病例对照研究. 中国胸心血管外科临床杂志, 2013, 20(3):294-297.
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18.	Konagai N, Cho M, Nakamura K, et al. Left atrial myxoma as a cause of acute myocardial infarction. Tex Heart Inst J, 2010, 37(1):125-126.
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20.	Bossert T, Gummert JF, Battellini R, et al. Surgical experience with 77 primary cardiac tumors. Interact Cardiovasc Thorac Surg, 2005, 4(4):311-315.

1. Panos A, Myers PO. Video-assisted cardiac myxoma resection:basket technique for complete and safe removal from the heart. Ann Thorac Surg, 2012, 93(4):e109-e110.
2. 谢基严, 周清华, 主译. 心胸外科学精要. 第2 版. 天津:科技翻译出版公司, 2010.649-653.
3. 王咏, 肖颖彬, 陈林, 等. 心脏肿瘤181 例外科治疗的临床分析. 中国胸心血管外科临床杂志, 2013, 20(2):155-158.
4. Svensson LG, Atik FA, Cosgrove DM, et al. Minimally invasive versus conventional mitral valve surgery:a propensity-matched comparison. J Thorac Cardiovasc Surg, 2010, 139(4):926-932.
5. 王潇, 陶凉, 陈绪发, 等. 右胸微创小切口二尖瓣置换术与传统二尖瓣置换术的对比分析. 中国胸心血管外科临床杂志, 2013, 20(2):139-143.
6. 陈和明, 刘立明, 胡建国. 右胸前外侧小切口微创二尖瓣置换术. 中南大学学报:医学版, 2010, 35(9):1005-1008.
7. Vollroth M, Seeburger J, Garbade J, et al. Minimally invasive mitral valve surgery is a very safe procedure with very low rates of conversion to full sternotomy. Eur J Cardiothorac Surg, 2012, 42(1):e13-e15.
8. Pfannmüller B, Misfeld M, Borger MA, et al. Isolated reoperative minimally invasive tricuspid valve operations. Ann Thorac Surg, 2012, 94(6):2005-2010.
9. Yu S, Xu X, Zhao B, et al. Totally thoracoscopic surgical resection of cardiac myxoma in 12 patients. Ann Thorac Surg, 2010, 90(2):674-676.
10. 刘化刚, 谷天祥, 修宗宜, 等. 左心房粘液瘤合并动脉栓塞的外科治疗. 中国胸心血管外科临床杂志, 2011, 18(6):576-577.
11. Schilling J, Engel AM, Hassan M, et al. Robotic excision of atrial myxoma. J Card Surg, 2012, 27(4):423-426.
12. 师恩祎, 谷天祥, 喻磊, 等. 微创与常规二尖瓣成形和置换术治疗单纯二尖瓣病变患者的病例对照研究. 中国胸心血管外科临床杂志, 2013, 20(3):294-297.
13. 魏来, 王春生, 沈金强, 等. Chitwood 法微创心脏瓣膜手术115 例临床分析. 中华外科杂志, 2011, 49(4):373-375.
14. Schmitto JD, Mokashi SA, Cohn LH. Past, present, and future of minimally invasive mitral valve surgery. J Heart Valve Dis, 2011, 20(5):493-498.
15. Mazine A, Pellerin M, Lebon JS, et al. Minimally invasive mitral valve surgery:influence of aortic clamping technique on early outcomes. Ann Thorac Surg, 2013, 96(6):2116-2122.
16. Vistarini N, Alloni A, Aiello M, et al. Minimally invasive videoassisted approach for left atrial myxoma resection. Interact Cardiovasc Thorac Surg, 2010, 10(1):9-11.
17. Hatemi AC, Gursoy M, Tongut A, et al. Left atriotomy versus right atriotomy trans-septal approach for left atrial myxoma. J Int Med Res, 2010, 38(1):276-281.
18. Konagai N, Cho M, Nakamura K, et al. Left atrial myxoma as a cause of acute myocardial infarction. Tex Heart Inst J, 2010, 37(1):125-126.
19. Cheng DC, Martin J, Lal A, et al. Minimally invasive versus conventional open mitral valve surgery:a meta-analysis and systematic review. Innovations (Phila), 2011, 6(2):84-103.
20. Bossert T, Gummert JF, Battellini R, et al. Surgical experience with 77 primary cardiac tumors. Interact Cardiovasc Thorac Surg, 2005, 4(4):311-315.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical Outcomes of Left Atrial Myxoma Resection via Right Anterolateral Minithoracotomy

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