Excision of a left atrial myxoma via a minimally-invasive technique: a possible routine access

We would like to present our experience of surgical excision of intracardiac tumors using a video-assisted minimally-invasive cardiac surgery (MIC) technique. An 83-year-old female patient received video-assisted cardiac surgery for excision of a left atrial tumor. The surgery was performed through a right anterior submammary minithoracotomy and guided by video-assisted endoscopic techniques by projected images on a video monitor while under femoro-femoral bypass. The myocardium was protected by single-dose antegrade crystalloid cardioplegia. The tumor was excised completely recording a 61-minute bypass time and a 103-minute total operative time. Histopathological examination revealed left atrial myxoma. Transthoracic echocardiography examination showed good ventricular function and the absence of residual tumors. The patient was satisfied by the cosmetic healing of the wound and was discharged eight days after the surgery. Video-assisted MIC surgery is technically feasible and could be applied as a routine access in all left atrial tumors without the fear of inadequate intraoperative exposure and its drawbacks.