Robotic excision of atrial myxoma

Advances in optics and instrumentation with the da Vinci S Surgical System have facilitated minimally invasive and robotic cardiac procedures including mitral valve repair and atrial myxoma excision. We report our retrospective data comparing robotically assisted myxoma excision with standard median sternotomy excision.

Data were collected for cardiac myxoma resection performed between January 2000 and December 2009. The resulting cohort included a total of 57 patients. These patients were grouped into two categories: robotic-assisted (n = 17) surgical procedures and traditional (nonrobotic; n = 40) surgical procedures. Presurgical and surgical risk factors were examined.

Univariate analysis comparing the surgical procedure groups and surgical risk factors found a significant difference in 3 of the 14 variables. Cannulation in all patients undergoing robotic-assisted cardiac myxoma excision was performed through cannulating the common femoral artery and vein while cannulation for the traditional procedures was performed using the aorta and atrium except for two patients. For aortic occlusion, 14 of the robotic-assisted cardiac myxoma patients had balloon occlusion and 34 of the traditional cardiac myxoma patients had aortic cross-clamp occlusion. Operating time was significantly shorter for robotic cases (2.7 hours) compared with traditional cases (3.5 hours).

Robotic excision of atrial myxomas is safe and may be an alternative to traditional open surgery in selected patients.