Giant right atrium myxoma resection: video-assisted thoracoscopic technique

A 68-year-old man was diagnosed with a very large right atrium mass that gave him symptoms of constitutional and right-sided heart failure. Echocardiography and magnetic resonance imaging showed tricuspid occlusion by the tumoural mass during diastole and suggested an implant base near the inferior vena cava-right atrium junction. A video-assisted thoracoscopic port-access approach was used to remove it surgically. Bicaval jugular and femoral cannulation for cardiopulmonary bypass was implemented. Antegrade del Nido cardioplegia was administered. Complete tumour resection was performed without complications, with excellent exposition and visualization for clean margins. The postoperative period was uneventful, and he was discharged on postoperative day 4. The pathology report confirmed a histologic diagnosis of myxoma. This minimally invasive approach caused hardly any surgical trauma to this fragile, malnourished patient with cardiac cachexia, did not jeopardize the clinical outcomes and protected him from potential serious complications derived from a conventional sternotomy and long stays in the intensive care unit and the hospital, thereby allowing him to recover functional capacity swiftly.