Totally Thoracoscopic Treatment of Cardiac Myxoma: Experience from 29 Cases and Review of the Literature
DOI:
https://doi.org/10.59958/hsf.7777Keywords:
cardiac myxoma, totally thoracoscopic surgery, minimally invasive surgeryAbstract
Background: Cardiac myxoma, a rare benign tumor, can cause significant patient morbidity if left untreated. Traditionally, treatment has involved open sternotomy; however, recent advancements now enable minimally invasive resection using totally thoracoscopic techniques. Methods: This retrospective study reviewed 29 cases of totally thoracoscopic resections of cardiac myxomas performed at our department between January 2019 and October 2022. Perioperative data were analyzed, and the surgical outcomes of a single surgeon's clinical experience were evaluated. Results: The study included 20 men and nine women, with a mean age of 49 ± 10.38 years. All surgeries were uneventful, with an average tumor size of 34.46 mm × 25.07 mm. The mean operation time was 230.17 ± 59.67 min, and the average cardiopulmonary bypass time was 93.14 ± 28.15 min. No intraoperative complications or postoperative deaths were reported. Follow-up transthoracic echocardiography at 12 months showed no residual intracardiac tumors or other abnormalities. Conclusion: Totally thoracoscopic resection of cardiac myxomas was demonstrated to be a safe and effective procedure, offering rapid recovery and a low complication rate, aligning with modern trends in minimally invasive cardiac surgery.
References
Rahouma M, Arisha MJ, Elmously A, El-Sayed Ahmed MM, Spadaccio C, Mehta K, et al. Cardiac tumors prevalence and mortality: A systematic review and meta-analysis. International Journal of Surgery (London, England). 2020; 76: 178–189.
Amano J, Nakayama J, Yoshimura Y, Ikeda U. Clinical classification of cardiovascular tumors and tumor-like lesions, and its incidences. General Thoracic and Cardiovascular Surgery. 2013; 61: 435–447.
Gošev I, Paić F, Durić Z, Gošev M, Ivčević S, Jakuš FB, et al. Cardiac myxoma the great imitators: comprehensive histopathological and molecular approach. International Journal of Cardiology. 2013; 164: 7–20.
Grebenc ML, Rosado-de-Christenson ML, Green CE, Burke AP, Galvin JR. Cardiac myxoma: imaging features in 83 patients. Radiographics: a Review Publication of the Radiological Society of North America, Inc. 2002; 22: 673–689.
Islam AKMM. Cardiac myxomas: A narrative review. World Journal of Cardiology. 2022; 14: 206–219.
Pinede L, Duhaut P, Loire R. Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases. Medicine. 2001; 80: 159–172.
Chitwood WR, Jr. Clarence Crafoord and the first successful resection of a cardiac myxoma. The Annals of Thoracic Surgery. 1992; 54: 997–998.
Pineda AM, Santana O, Cortes-Bergoderi M, Lamelas J. Is a minimally invasive approach for resection of benign cardiac masses superior to standard full sternotomy? Interactive Cardiovascular and Thoracic Surgery. 2013; 16: 875–879.
Moscarelli M, Rahouma M, Nasso G, di Bari N, Speziale G, Bartolomucci F, et al. Minimally invasive approaches to primary cardiac tumors: A systematic review and meta-analysis. Journal of Cardiac Surgery. 2021; 36: 483–492.
Elbardissi AW, Dearani JA, Daly RC, Mullany CJ, Orszulak TA, Puga FJ, et al. Survival after resection of primary cardiac tumors: a 48-year experience. Circulation. 2008; 118: S7–S15.
Reynen K. Cardiac myxomas. The New England Journal of Medicine. 1995; 333: 1610–1617.
Ilcheva L, Risteski P, Tudorache I, Häussler A, Papadopoulos N, Odavic D, et al. Beyond Conventional Operations: Embracing the Era of Contemporary Minimally Invasive Cardiac Surgery. Journal of Clinical Medicine. 2023; 12: 7210.
Gao C, Yang M, Wang G, Wang J, Xiao C, Wu Y, et al. Excision of atrial myxoma using robotic technology. The Journal of Thoracic and Cardiovascular Surgery. 2010; 139: 1282–1285.
Zhou K, Yang L, He BC, Ke YJ, Yang YC, Yan Q, et al. Total thoracoscopic repair of ventricular septal defect: A single-center experience. Journal of Cardiac Surgery. 2021; 36: 2213–2218.
Chen Y, Huang LC, Chen DZ, Chen LW, Zheng ZH, Dai XF. Totally endoscopic mitral valve surgery: early experience in 188 patients. Journal of Cardiothoracic Surgery. 2021; 16: 91.
Pitsis A, Boudoulas H, Boudoulas KD. Operative steps of totally endoscopic aortic valve replacement. Interactive Cardiovascular and Thoracic Surgery. 2020; 31: 424.
Wei P, Liu J, Ma J, Liu Y, Tan T, Wu H, et al. Thoracoscopic Trans-mitral Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy in the Elderly. Frontiers in Cardiovascular Medicine. 2022; 9: 827860.
Yilmaz A, Robic B, Starinieri P, Polus F, Stinkens R, Stessel B. A new viewpoint on endoscopic CABG: technique description and clinical experience. Journal of Cardiology. 2020; 75: 614–620.
Chen Z, Ke Y, Xie X, Huang J, Zeng Q, Guo H, et al. Beating-Heart Totally Endoscopic Tricuspid Valvuloplasty in Reoperative Cardiac Surgery. The Annals of Thoracic Surgery. 2019; 107: e79–e82.
Langenaeken T, van den Berg M, Kaya A, Yilmaz A. Thoracoscopic management of iatrogenic cardiac perforations. Journal of Cardiovascular Electrophysiology. 2022; 33: 1366–1370.
Liu X, Wu Y, Zhu J, Lv X, Tang Y, Sun J, et al. Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients. European Journal of Medical Research. 2014; 19: 13.
Tarcan O, Köksal P, Çomaklı H, Sezer GB, Günaydın G, Uslu HY, et al. Closed chest resection of left ventricular myxoma through thoracoscopic assistance. The Annals of Thoracic Surgery. 2011; 91: 1988–1990.
Dang QH, Le NT, Tran DD, Ngo THL. Totally Endoscopic Resection of Giant Left Atrial Myxoma Without Robotic Assistance. Innovations (Philadelphia, Pa.). 2018; 13: 136–139.
Xu K, Ma Z, Li B, Wang Z, Song H, Bai X, et al. Totally thoracoscopic surgical resection of left ventricular benign tumor. JTCVS Techniques. 2023; 20: 116–122.
Yu S, Xu X, Zhao B, Jin Z, Gao Z, Wang Y, et al. Totally thoracoscopic surgical resection of cardiac myxoma in 12 patients. The Annals of Thoracic Surgery. 2010; 90: 674–676.
Deng L, Zhang GW, Liu ZH, Meng WX, Liu HY. Totally thoracoscopic surgery for atrial myxomas resection and atrial septal defect repair. European Review for Medical and Pharmacological Sciences. 2017; 21: 569–575.
Zhao F, Chen T, Tang Y, Chen Q, Jiang N, Guo Z. Totally thoracoscopic surgery for treating left atrial myxoma. Medicine. 2021; 100: e27819.
Nam NH, Huu NC, Nguyen TT, Trung HV, Uoc NH. Totally endoscopic resection of atrial myxoma: early results of 26 patients in E hospital. Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam. 2021; 33: 38–43.
Dang HQ, Le HT, Dinh LN. Endoscopic port access resection of left atrial myxoma: Clinical outcomes and a single surgeon's learning curve experience. JTCVS Techniques. 2024; 23: 52–62.
Liu Y, Wang H, Huang H, Han F, Zhuang J, Ou Y, et al. Management of left atrial myxoma in pregnant women: a case series. Journal of Cardiothoracic Surgery. 2024; 19: 197.
Published
How to Cite
Issue
Section
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
