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Minimal access approach for surgical management of cardiac tumors
E Ravikumar1, N Pawar, R Gnanamuthu
1Department of Thoracic and Cardiovascular Surgery, Christian Medical College Hospital, Vellore, India. eravikumar@hotmail.com
Background:
Following our experience with minimally invasive valve replacement operation, we utilized this technique for surgical management of cardiac tumors.
Methods:
Between April 1997 and September 1999, 5 consecutive patients with cardiac tumors underwent minimally invasive excision of the tumors. The patients were 4 women and 1 man with an age range of 32 to 50 years. The tumor was located in the left atrium in 4 patients and the right atrium in 1 patient. The common presenting symptoms were dyspnea on exertion (100%), chest pain (60%), palpitation (60%), and transient ischemic attack (20%). Diagnosis was established preoperatively by echocardiography only.
Results:
In 2 patients the approach was right parasternal and the subsequent 3 patients had direct-access partial sternotomy. The myxoma was resected transseptally in all patients. There was no hospital mortality. One patient had postoperative embolic episode leading to left hemiparesis. Follow-up did not reveal any complication related to this technique and all were in New York Heart Association (NYHA) functional class I.
Conclusions:
Minimal access partial sternotomy is an effective approach that adheres to all the identified surgical principles in successful removal of these tumors. The smaller incision does not compromise the efficacy or safety of the operation, reduces hospital stay, and has a good cosmetic result.
Insights
Minimally invasive surgery effectively removes cardiac tumors with no hospital mortality. This approach offers good cosmetic results and reduces hospital stay for patients.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Minimally Invasive Procedures
Background:
- Experience with minimally invasive valve replacement informed the use of this technique for cardiac tumor management.
- Cardiac tumors present with symptoms including dyspnea, chest pain, palpitations, and transient ischemic attacks.
Purpose of the Study:
- To evaluate the efficacy and safety of minimally invasive techniques for cardiac tumor excision.
- To assess the outcomes of minimal access partial sternotomy in cardiac tumor surgery.
Main Methods:
- Five consecutive patients (4 women, 1 man; age 32-50) with cardiac tumors underwent minimally invasive excision between April 1997 and September 1999.
- Tumors were located in the left atrium (4 patients) and right atrium (1 patient).
- Diagnosis was confirmed preoperatively using echocardiography; tumors were resected transseptally.
Main Results:
- Two patients had a right parasternal approach, and three had a direct-access partial sternotomy.
- No hospital mortality occurred.
- One patient experienced a postoperative embolic event causing left hemiparesis; however, follow-up showed no technique-related complications, with all patients in New York Heart Association (NYHA) functional class I.
Conclusions:
- Minimal access partial sternotomy is an effective surgical approach for cardiac tumors, adhering to surgical principles.
- The smaller incision does not compromise efficacy or safety, leading to reduced hospital stay and improved cosmetic outcomes.