Off-Pump Resection of an Epicardial Cyst by Using a Minimally Invasive Approach

Area of Science:

• Cardiology
• Thoracic Surgery
• Medical Imaging

Background:

• Epicardial cysts are rare congenital anomalies that can cause significant cardiac compression.
• Left ventricular diastolic dysfunction can result from extrinsic compression by cardiac masses.
• Minimally invasive surgical techniques are increasingly explored for cardiac pathologies.

Observation:

• A 25-year-old male presented with palpitations due to a large (6.8 x 3.8 cm) epicardial cyst originating from the left ventricle.
• The cyst caused compression of the left atrium and ventricle, leading to diastolic dysfunction.
• Computed tomography revealed the circumflex artery coursing near or through the cyst.

Findings:

• Successful resection of the epicardial cyst was achieved using a left mini-thoracotomy with thoracoscopic assistance.
• The procedure avoided the need for cardiopulmonary bypass.
• Post-operative improvement in left ventricular diastolic function was observed.

Implications:

• Minimally invasive thoracoscopic resection is a viable and effective treatment for large epicardial cysts on the left side of the heart.
• This approach can potentially improve cardiac function and alleviate symptoms associated with cyst compression.
• Further research into thoracoscopic techniques for cardiac cyst management is warranted.