Right mini-thoracotomy for cardiac myxoma resection resulted in no early mortality or clinical strokes, a 25.7% incidence of silent cerebral embolism, and one tumor recurrence over a median 24.8-month follow-up.
Cohort (n=64)
No
Does cardiac myxoma resection through right mini-thoracotomy result in acceptable rates of postoperative cerebral embolism and tumor recurrence in patients with cardiac myxoma?
Cardiac myxoma resection via right mini-thoracotomy is a safe and effective alternative to median sternotomy, demonstrating excellent early clinical outcomes and a low rate of tumor recurrence.
Background: With recent advances in cardiac surgery through minimal access, mini-thoracotomy has emerged as an excellent alternative for cardiac myxoma resection. This study analyzed the surgical results of this approach, focusing on postoperative cerebral embolism and tumor recurrence. Methods: We retrospectively reviewed 64 patients (mean age, 56.0±12.1 years; 40 women) who underwent myxoma resection through mini-thoracotomy from October 2008 to July 2020. We conducted femoral cannulation and antegrade cardioplegic arrest in all patients. Patient characteristics and perioperative data, including brain diffusion-weighted magnetic resonance imaging (DWI) findings, were collected. Medium-term echocardiographic follow-up was performed. Results: Thirteen patients (20.3%) had a history of preoperative stroke, and 7 (11.7%) had dyspnea with New York Heart Association functional class III or IV. Sixty-one cases (95.3%) had myxomas in the left atrium. The mean cardiopulmonary bypass and cardiac ischemic times were 69.0±28.6 and 34.1±15.0 minutes, respectively. Sternotomy conversion was not performed in any case, and 50 patients (78.1%) were extubated in the operating room. No early mortality or postoperative clinical stroke occurred. Postoperative DWI was performed in 32 (53%) patients, and 7 (22%) showed silent cerebral embolisms. One patient underwent reoperation for tumor recurrence during the study period; in that patient, a genetic study confirmed the Carney complex. Conclusion: Mini-thoracotomy for cardiac myxoma resection showed acceptable clinical and neurological outcomes. In the medium-term echocardiographic follow-up, reliable resection was proven, with few recurrences. This approach is a promising alternative for cardiac myxoma resection.
Shin et al. (Thu,) conducted a cohort in Cardiac myxoma (n=64). Right mini-thoracotomy was evaluated on Postoperative clinical stroke. Right mini-thoracotomy for cardiac myxoma resection resulted in no early mortality or clinical strokes, a 25.7% incidence of silent cerebral embolism, and one tumor recurrence over a median 24.8-month follow-up.