Minimally invasive video-assisted approach for left atrial myxoma resection

Minimally invasive surgery has become the standard approach for several cardiac diseases. We report in the present study our ten-year experience with endoscopic cardiac surgery for left atrial myxoma resection. Between January 1998 and January 2008, 14 patients (median age: 61 years) underwent surgery for left atrial myxoma resection at our institution. The Heartport access system and the video-assistance were systematically employed to provide excellent vision and facilitate surgery. The aortic clamping was obtained with an 'EndoClamp' in 11 cases (using a central or peripheral endoaortic balloon, depending on the site of the arterial cannulation) or transthoracically with the Portaclamp system in two cases and the Chitwood clamp in one case. The average time needed for cross-clamping was 49+/-29 min, with a mean cardiopulmonary bypass (CPB) time of 88+/-57 min. There were no early or late hospital deaths. Mean intensive care unit and hospital stay were three and eight days, respectively. The mean follow-up time was 64 months and there was no evidence of residual or recurrent tumor. There were two late deaths due to acute ischemic stroke. Minimally invasive video-assisted surgery for left atrial myxoma resection is a safe, reproducible and cosmetic operation and can be considered an effective oncologic approach as an alternative to standard sternotomy.