Endoscopic Cardiac Tumor Resection

OLV Ziekenhuis Aalst, Alost, Flemish, Belgium
The Annals of thoracic surgery (Impact Factor: 3.85). 07/2007; 83(6):2142-6. DOI: 10.1016/j.athoracsur.2007.01.064
Source: PubMed


The purpose of this study is to report our 9 years' experience with endoscopic cardiac tumor resection using the port access approach.
From March 1997 to December 2005, 27 patients (mean age, 56.2 +/- 16.9 years; 70% female) underwent endoscopic cardiac tumor resection using endocardiopulmonary bypass and endoaortic-balloon clamp technique. Nineteen (70%) patients presented in New York Heart Association class I, 4 patients presented with embolic stroke, and 4 patients presented with atrial arrhythmias. All patients underwent echocardiography on admission, intraoperatively, at discharge, and at follow-up evaluation. Eight patients additionally required mitral valve replacement (n = 1), tricuspid valve replacement (n = 1), mitral valve repair (n = 2), mini-maze (n = 1), and closure of patent foramen ovale (n = 3). Mean follow-up was 3.4 +/- 2.7 years.
Mean endoaortic-balloon clamp and endocardiopulmonary bypass times were 68.8 +/- 30.8 minutes and 112.2 +/- 41.5 minutes, respectively. There were no conversions to sternotomy. Tumors resected were classified as left atrial myxoma (n = 20), right atrial myxoma (n = 3), lipoma (n = 1), intravenous leiomyoma involving the inferior vena cava and the tricuspid valve (n = 1), plexiform tumor of the sinoatrial node (n = 1), and papillary fibroelastoma of aortic valve noncoronary cusp (n = 1). There were no hospital deaths. Mean intensive care unit and hospital stays were 1.4 +/- 1.1 days and 7.3 +/- 3.4 days, respectively. Postoperative complications were evolving stroke (n = 1), re-exploration for bleeding (n = 1), and myocardial ischemia requiring stenting (n = 1). Follow-up failed to demonstrate residual or recurrent tumor. One patient had a small residual atrial septal defect. Ninety-two percent of patients appreciated the cosmetic result and fast recovery.
Endoscopic cardiac tumor resection is feasible and a valid oncologic approach with an attractive cosmetic advantage over median sternotomy.

Download full-text


Available from: Filip P Casselman
  • Source
    • "Even the right heart can be resected almost completely and reconstructed using Fontan circulation [87]. In the literature, there is also a case of total resection of the left atrium and its orthotopic allograft transplantation due to leiomyosarcoma [88]. On the other hand, the analysis undertaken by Vitovskiĭ showed that breadth of the operation has no significant effect on the clinical status of patients in the immediate period after surgery [89]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Cardiac tumors are assumed to be a rare entity. Metastases to the heart are more frequent than primary lesions. Sarcomas make up the majority of cardiac malignant neoplasms. Among them angiosarcoma is the most common and associated with the worst prognosis. Malignant fibrous histiocytoma comprises the minority of cardiac sarcomas and has uncertain etiology as well as pathogenesis. Transthoracic echocardiography remains the widely available screening examination for the initial diagnosis of a cardiac tumor. The clinical presentation is non-specific and the diagnosis is established usually at an advanced stage of the disease. Sarcomas spread preferentially through blood due to their immature vessels without endothelial lining. Surgery remains the method of choice for treatment. Radicalness of the excision is still the most valuable prognostic factor. Adjuvant therapy is unlikely to be effective. The management of cardiac sarcomas must be individualized due to their rarity and significant differences in the course of disease.
    Full-text · Article · Feb 2014 · Archives of Medical Science
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cardiac hemengioma’s are rare tumors and their management through minimally invasive endoscopic technique is not well documented. A 64-year-old lady presented with a history of worsening shortness of breath and arrhythmias. She was known to have hypertension, morbid obesity and chronic obstructive lung disease. Further investigations revealed a left atrial tumor, which was confirmed on coronary angiography by a “tumor blush”. Surgery was performed for this suspected vascular tumor through right mini thoracotomy using minimally invasive endoscopic techniques and histology confirmed it as a hemangioma. Although cardiac hemangiomas are rare, the same minimally invasive strategies that have been developed tackling the more common cardiac tumors can be applied successfully. KeywordsTumor-Arrhythmia-Atrium
    Preview · Article · Jun 2010 · Indian Journal of Thoracic and Cardiovascular Surgery

  • No preview · Article · Jan 2004
Show more