Key result
Two-port endoscopic myxoma resection under ventricular fibrillation simplifies surgery by eliminating cross-clamping.
Why the study?
This report describes a reproducible 2-port, 3-dimensional totally endoscopic technique for left atrial myxoma resection under ventricular fibrillation without aortic cross-clamping.
Describes a 2-port, 3-dimensional totally endoscopic technique for left atrial myxoma resection under ventricular fibrillation that simplifies the procedure in selected patients by avoiding aortic clamping, root cannulation, and cardioplegia.
May offer a minimally invasive option for left atrial myxoma resection; leaves open the need for comparative trials on safety and outcomes.
OBJECTIVE: To describe a reproducible 2-port, 3-dimensional totally endoscopic technique for left atrial myxoma resection under ventricular fibrillation without aortic cross-clamping. KEY STEPS: Peripheral cardiopulmonary bypass is established through femoral cannulation. After 2 right thoracic ports are positioned, ventricular fibrillation is induced, the left atrium is opened, and a left atrial vent is inserted. The tumor is removed en bloc with an adequate septal margin. Continuous carbon dioxide insufflation, titrated venting, a gently blood-filled left atrium, and transesophageal echocardiography-guided de-airing provide embolic protection. POTENTIAL PITFALLS: Aortic regurgitation, interatrial shunting, inappropriate venting, tumor fragmentation, and prolonged fibrillatory arrest can compromise safety. TAKE-HOME MESSAGES: In carefully selected patients, a short fibrillatory interval can simplify 2-port myxoma resection by avoiding aortic clamping, root cannulation, and cardioplegia. Meticulous left-heart decompression and de-airing are essential.
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Kim et al. (2026) studied Left atrial myxoma. 2-port, 3-dimensional totally endoscopic left atrial myxoma resection under ventricular fibrillation without aortic cross-clamping was evaluated. Two-port, 3-dimensional totally endoscopic myxoma resection under ventricular fibrillation simplifies surgery by avoiding aortic cross-clamping, root cannulation, and cardioplegia.
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