Totally endoscopic resection of atrial myxoma: early results of 26 patients in E hospital

Nguyen Hoang Nam, Nguyen Cong Huu, Tran Thuy Nguyen, Hoang Van Trung, Do Duc Thinh, Ngo Thanh Hung, Pham Thanh Dat, Le Ngoc Thanh, Nguyen Huu Uoc


Tóm tắt

Objective: Myxoma is the most common form of non-malignant tumor that arises from connective tissue. Totally endoscopic surgery without robotic assistance can resect the entire atrial myxoma. This study aim to evaluate the early results of this surgical method. Methods: From January 2019 to April 2021, 26 patients (20 females, 6 males, mean age 49.5 ± 14.3) were diagnosed with atrial myxoma. All tumors of those patients were resected by totally endoscopic surgery. We evaluated the early outcome of this method based on the following criteria: mortality rates, conversion to open surgery, cardiopulmonary bypass time, aortic cross-clamp time, postoperative time. Results: Totally endoscopic surgery to resect atrial myxoma was successfully performed in all patients with surgical ports on the thoracic wall. The largest incision was not more than 1.5 cm in diameter. Mean cardiopulmonary bypass time was 134 ± 39 minutes, aortic cross-clamp time was 81.4 ± 26.4 minutes, mechanical ventilation time was 10.5 ± 4.6 hours, ICU length of stay was 2.1 ± 0.9 days, postoperative time was 6.9 ± 5.4 days. We had one case in which the excision of myxoma was performed contemporaneously with mitral valve annuloplasty. Conclusions: Initial outcomes of totally endoscopic surgery to resect atrial myxomas were satisfactory. However, to fully evaluate the effectiveness of this method, we need to conduct a long-term follow-up of these patients.


Tài liệu tham khảo

1. Reynen K. Cardiac myxomas. N Engl J Med. 1995; 333(24):1610-1617.
2. Modi P, Hassan A, Chitwood WR Jr. Minimally invasive mitral valve surgery: a systematic review and meta-analysis (2008). Eur J Cardiothorac Surg. 2008; 34:943-952
3. Nguyen Cong Huu, Nguyen Hoang Nam, Nguyen Trung Hieu et al. Surgery with thoracoscopic support to close the atrial septal defect under extracorporeal circulation, beating heart, without aortic cross-clamp . Vietnam journal of endolaparoscopic surgery. 2014; 3(3): 29-33
4. Casselman FP, Slyke SV, Dom H, Lambrechts DL, Vermeulen Y, Vanermen H. Endoscopic mitral valve repair: feasible, reproductive, and durable. J Thorac Cardiovasc Surg. 2003; 125:273-282
5. Chitwood WR Jr. Clarence Crafoord and the first successful resection of a cardiac myxoma. Ann Thorac Surg. 1992 Nov;54(5):997-8.
6. Schmitto JD, Mokashi SA, Cohn LH. Minimally-Invasive Valve Surgery. Journal of the American College of Cardiology. 2010; 56(6):455-462
7. Argenziano M, Oz MC, Kohmoto T et al. Totally endoscopic atrial septal defect repair with robotic assistance. Circulation. 2003;108 Suppl 1: II191-II194
8. 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? Interact Cardiovasc Thorac Surg. 2013;16(6):875-879.
9. Falk V, Walther T, Autschbach R et al. Robot-assisted minimally invasive solo mitral valve operation. J Thorac Cardiovasc Surg. 1998 Feb;115(2):470-1.
10. Gao C, Yang M, Wang G et al. Excision of atrial myxoma using robotic technology. J Thorac Cardiovasc Surg. 2010 May;139(5):1282-1285.
11. Yu S, Xu X, Zhao B et al. Totally thoracoscopic surgical resection of cardiac myxoma in 12 patients. Ann Thorac Surg. 2010 Aug;90(2):674-6.
12. Murphy DA, Miller JS, Langford DA. Robot-assisted endoscopic excision of left atrial myxomas. J Thorac Cardiovasc Surg. 2005 Aug;130(2):596-597