Key result
Minimally invasive and robotic myxoma resection matches sternotomy safety while shortening ICU stays.
Why the study?
Surgical resection of cardiac myxomas can be performed via conventional median sternotomy, minimally invasive, or robotic-assisted approaches, but their outcomes, advantages, and limitations needed evaluation.
Do minimally invasive or robotic-assisted surgical approaches improve outcomes compared to median sternotomy in patients with cardiac myxoma?
Systematic Review
Do minimally invasive or robotic-assisted surgical approaches improve outcomes compared to median sternotomy in patients with cardiac myxoma?
Minimally invasive and robotic-assisted approaches for cardiac myxoma resection offer comparable safety and faster recovery than median sternotomy, though they are technically demanding and limited by cost.
Median sternotomy remains standard for cardiac myxoma resection; leaves open whether minimally invasive or robotic approaches improve outcomes in selected patients.
Background: Cardiac myxomas are benign tumors of the heart. They occur mostly in the left atrium. The preferred treatment is surgical resection, which can be performed via conventional median sternotomy, minimally invasive, or robotic-assisted approaches. This study aimed to evaluate the outcomes, advantages, and limitations of these surgical methods, with a focus on their safety, efficacy, and impact on patient recovery. Methods: This systemic review was conducted according to PRISMA guidelines. The chosen databases were systematically searched using the keywords "cardiac myxoma", "resection", "approach", "minimally invasive", and "robotic surgery". The comparison between the surgical strategies was based on thirteen articles, which met the inclusion criteria. Results: Median sternotomy remains the standard technique, providing excellent surgical access but is associated with longer hospital stays, higher blood loss, and increased risk of complications such as stroke. Minimally invasive approaches demonstrated comparable safety with shorter ICU stays, reduced blood loss, and lower postoperative pain but presented challenges, including limited exposure and longer procedure times. Robotic-assisted surgery showed potential as a safe alternative but was limited by high costs and technical demands. However, the data on minimally invasive and robotic methods are limited due to the rarity of cardiac myxomas. Conclusions: The choice of surgical technique should be individualised by considering the tumour size, location, patient condition, and surgeon expertise. Routine postoperative echocardiographic monitoring is essential to detect residual or recurrent tumours. Further studies are needed to validate the long-term efficacy of minimally invasive and robotic approaches.
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Mendyka et al. (2024) conducted a systematic review in Cardiac myxoma. Minimally invasive and robotic-assisted approaches vs. Conventional median sternotomy was evaluated on Safety, efficacy, and impact on patient recovery. Minimally invasive and robotic approaches for cardiac myxoma resection demonstrated comparable safety to median sternotomy with shorter ICU stays, though data remain limited.
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