Surgical Outcomes of Cardiac Myxoma Resection Through Right Mini-Thoracotomy
Background: With recent advances in cardiac surgery through minimal access, mini-thoracotomy has emerged as an excellent alternative for cardiac myxoma resection. This study analyzed the surgical results of this approach, focusing on postoperative cerebral embolism and tumor recurrence. Methods:...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic & Cardiovascular Surgery
2023-01-01
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| Series: | Journal of Chest Surgery |
| Subjects: |
| _version_ | 1828070667376918528 |
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| author | Changwon Shin Min Ho Ju Chee-Hoon Lee Mi Hee Lim Hyung Gon Je |
| author_facet | Changwon Shin Min Ho Ju Chee-Hoon Lee Mi Hee Lim Hyung Gon Je |
| author_sort | Changwon Shin |
| collection | DOAJ |
| description | Background: With recent advances in cardiac surgery through minimal access, mini-thoracotomy
has emerged as an excellent alternative for cardiac myxoma resection. This study
analyzed the surgical results of this approach, focusing on postoperative cerebral embolism
and tumor recurrence.
Methods: We retrospectively reviewed 64 patients (mean age, 56.0±12.1 years; 40 women)
who underwent myxoma resection through mini-thoracotomy from October 2008 to
July 2020. We conducted femoral cannulation and antegrade cardioplegic arrest in all patients.
Patient characteristics and perioperative data, including brain diffusion-weighted
magnetic resonance imaging (DWI) findings, were collected. Medium-term echocardiographic
follow-up was performed.
Results: Thirteen patients (20.3%) had a history of preoperative stroke, and 7 (11.7%) had
dyspnea with New York Heart Association functional class III or IV. Sixty-one cases (95.3%)
had myxomas in the left atrium. The mean cardiopulmonary bypass and cardiac ischemic
times were 69.0±28.6 and 34.1±15.0 minutes, respectively. Sternotomy conversion was not
performed in any case, and 50 patients (78.1%) were extubated in the operating room. No
early mortality or postoperative clinical stroke occurred. Postoperative DWI was performed
in 32 (53%) patients, and 7 (22%) showed silent cerebral embolisms. One patient underwent
reoperation for tumor recurrence during the study period; in that patient, a genetic
study confirmed the Carney complex.
Conclusion: Mini-thoracotomy for cardiac myxoma resection showed acceptable clinical
and neurological outcomes. In the medium-term echocardiographic follow-up, reliable
resection was proven, with few recurrences. This approach is a promising alternative for
cardiac myxoma resection. |
| first_indexed | 2024-04-11T00:41:23Z |
| format | Article |
| id | doaj.art-679050c6de384bf294006899ea3c9337 |
| institution | Directory Open Access Journal |
| issn | 2765-1606 2765-1614 |
| language | English |
| last_indexed | 2024-04-11T00:41:23Z |
| publishDate | 2023-01-01 |
| publisher | Korean Society for Thoracic & Cardiovascular Surgery |
| record_format | Article |
| series | Journal of Chest Surgery |
| spelling | doaj.art-679050c6de384bf294006899ea3c93372023-01-06T05:24:05ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142023-01-01561424810.5090/jcs.22.094Surgical Outcomes of Cardiac Myxoma Resection Through Right Mini-ThoracotomyChangwon Shin0https://orcid.org/0000-0003-2135-6287Min Ho Ju1https://orcid.org/0000-0001-7839-8598Chee-Hoon Lee2https://orcid.org/0000-0002-0456-225XMi Hee Lim3https://orcid.org/0000-0002-0167-7836Hyung Gon Je4https://orcid.org/0000-0003-4713-2898Pusan National University School of MedicinePusan National University School of MedicinePusan National University School of MedicinePusan National University School of MedicinePusan National University School of MedicineBackground: With recent advances in cardiac surgery through minimal access, mini-thoracotomy has emerged as an excellent alternative for cardiac myxoma resection. This study analyzed the surgical results of this approach, focusing on postoperative cerebral embolism and tumor recurrence. Methods: We retrospectively reviewed 64 patients (mean age, 56.0±12.1 years; 40 women) who underwent myxoma resection through mini-thoracotomy from October 2008 to July 2020. We conducted femoral cannulation and antegrade cardioplegic arrest in all patients. Patient characteristics and perioperative data, including brain diffusion-weighted magnetic resonance imaging (DWI) findings, were collected. Medium-term echocardiographic follow-up was performed. Results: Thirteen patients (20.3%) had a history of preoperative stroke, and 7 (11.7%) had dyspnea with New York Heart Association functional class III or IV. Sixty-one cases (95.3%) had myxomas in the left atrium. The mean cardiopulmonary bypass and cardiac ischemic times were 69.0±28.6 and 34.1±15.0 minutes, respectively. Sternotomy conversion was not performed in any case, and 50 patients (78.1%) were extubated in the operating room. No early mortality or postoperative clinical stroke occurred. Postoperative DWI was performed in 32 (53%) patients, and 7 (22%) showed silent cerebral embolisms. One patient underwent reoperation for tumor recurrence during the study period; in that patient, a genetic study confirmed the Carney complex. Conclusion: Mini-thoracotomy for cardiac myxoma resection showed acceptable clinical and neurological outcomes. In the medium-term echocardiographic follow-up, reliable resection was proven, with few recurrences. This approach is a promising alternative for cardiac myxoma resection.minimally invasive surgical proceduresthoracotomymyxomaembolismcarney complex |
| spellingShingle | Changwon Shin Min Ho Ju Chee-Hoon Lee Mi Hee Lim Hyung Gon Je Surgical Outcomes of Cardiac Myxoma Resection Through Right Mini-Thoracotomy Journal of Chest Surgery minimally invasive surgical procedures thoracotomy myxoma embolism carney complex |
| title | Surgical Outcomes of Cardiac Myxoma Resection Through Right Mini-Thoracotomy |
| title_full | Surgical Outcomes of Cardiac Myxoma Resection Through Right Mini-Thoracotomy |
| title_fullStr | Surgical Outcomes of Cardiac Myxoma Resection Through Right Mini-Thoracotomy |
| title_full_unstemmed | Surgical Outcomes of Cardiac Myxoma Resection Through Right Mini-Thoracotomy |
| title_short | Surgical Outcomes of Cardiac Myxoma Resection Through Right Mini-Thoracotomy |
| title_sort | surgical outcomes of cardiac myxoma resection through right mini thoracotomy |
| topic | minimally invasive surgical procedures thoracotomy myxoma embolism carney complex |
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