Right Mini-Thoracotomy versus Standard Sternotomy for Surgical Excision of Atrial Myxomas

Introduction: Atrial myxomas are rare benign tumors; causing obstructive or embolic complications, or even death, depending on their site and size. Therefore, once diagnosed, it should be surgically resected. Atrial myxomas are present about 75% in left atrium (LA) and about 15% in right atrium (RA)...

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Main Author: Yasser Mubarak
Format: Article
Language:English
Published: Mashhad University of Medical Sciences 2021-06-01
Series:Journal of Cardio-Thoracic Medicine
Subjects:
Online Access:https://jctm.mums.ac.ir/article_17798_e3ddc20a63c2ec8d06057bf4a38f3630.pdf
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spelling doaj-a8cf89c4f6094608b7e1375f6c106a982021-06-20T03:30:06ZengMashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine 2345-24472322-57502021-06-019279880410.22038/jctm.2021.55438.131217798Right Mini-Thoracotomy versus Standard Sternotomy for Surgical Excision of Atrial MyxomasYasser Mubarak0Thoracic Surgeon, Cardiothoracic Surgery Department, Faculty of Medicine, Minia University, Egypt. Madinah Cardiac Center, King Fahad Hospital, Madinah, KSA.Introduction: Atrial myxomas are rare benign tumors; causing obstructive or embolic complications, or even death, depending on their site and size. Therefore, once diagnosed, it should be surgically resected. Atrial myxomas are present about 75% in left atrium (LA) and about 15% in right atrium (RA). Early diagnosis is a challenge because of nonspecific manifestations, and sometimes is asymptomatic and may be discovered accidentally during transthoracic echography (TTE).Minimally invasive cardiac surgery (MICS) has benefits over sternotomy include cosmetically, less pain, and shorter total hospital stay. Materials and Methods:Between January 2011 to December 2020, (50) patients [30 Sternotomy, 20 MICS] underwent surgery for isolated resection of cardiac myxoma. We reported outcomes; cardiopulmonary bypass (CPB) time, aortic cross-clamp (ACC) time, conversion to median sternotomy (ST), total hospital stay, complications (stroke, renal failure, respiratory failure, reoperation, and infection), pain, patient¢s satisfaction, recurrence and survival. Follow-up time was from 6-months to 3-years.  Results: There is no significant difference in CPB or cross-clamp time between groups. No minimal invasive (MI) cases required conversion to a median ST. Total hospital stay is shorter in the MI group by 2.2 days (p-value = 0.045).  No differences present in morbidity or mortality between two groups. Conclusions: Surgical resection of atrial myxoma resection by minimal invasive approach is safe, feasible, and favored over sternotomyhttps://jctm.mums.ac.ir/article_17798_e3ddc20a63c2ec8d06057bf4a38f3630.pdfmyxomamedian sternotomyminimal invasive cardiac surgeryright anterolateral mini-thoracotomy
collection DOAJ
language English
format Article
sources DOAJ
author Yasser Mubarak
spellingShingle Yasser Mubarak
Right Mini-Thoracotomy versus Standard Sternotomy for Surgical Excision of Atrial Myxomas
Journal of Cardio-Thoracic Medicine
myxoma
median sternotomy
minimal invasive cardiac surgery
right anterolateral mini-thoracotomy
author_facet Yasser Mubarak
author_sort Yasser Mubarak
title Right Mini-Thoracotomy versus Standard Sternotomy for Surgical Excision of Atrial Myxomas
title_short Right Mini-Thoracotomy versus Standard Sternotomy for Surgical Excision of Atrial Myxomas
title_full Right Mini-Thoracotomy versus Standard Sternotomy for Surgical Excision of Atrial Myxomas
title_fullStr Right Mini-Thoracotomy versus Standard Sternotomy for Surgical Excision of Atrial Myxomas
title_full_unstemmed Right Mini-Thoracotomy versus Standard Sternotomy for Surgical Excision of Atrial Myxomas
title_sort right mini-thoracotomy versus standard sternotomy for surgical excision of atrial myxomas
publisher Mashhad University of Medical Sciences
series Journal of Cardio-Thoracic Medicine
issn 2345-2447
2322-5750
publishDate 2021-06-01
description Introduction: Atrial myxomas are rare benign tumors; causing obstructive or embolic complications, or even death, depending on their site and size. Therefore, once diagnosed, it should be surgically resected. Atrial myxomas are present about 75% in left atrium (LA) and about 15% in right atrium (RA). Early diagnosis is a challenge because of nonspecific manifestations, and sometimes is asymptomatic and may be discovered accidentally during transthoracic echography (TTE).Minimally invasive cardiac surgery (MICS) has benefits over sternotomy include cosmetically, less pain, and shorter total hospital stay. Materials and Methods:Between January 2011 to December 2020, (50) patients [30 Sternotomy, 20 MICS] underwent surgery for isolated resection of cardiac myxoma. We reported outcomes; cardiopulmonary bypass (CPB) time, aortic cross-clamp (ACC) time, conversion to median sternotomy (ST), total hospital stay, complications (stroke, renal failure, respiratory failure, reoperation, and infection), pain, patient¢s satisfaction, recurrence and survival. Follow-up time was from 6-months to 3-years.  Results: There is no significant difference in CPB or cross-clamp time between groups. No minimal invasive (MI) cases required conversion to a median ST. Total hospital stay is shorter in the MI group by 2.2 days (p-value = 0.045).  No differences present in morbidity or mortality between two groups. Conclusions: Surgical resection of atrial myxoma resection by minimal invasive approach is safe, feasible, and favored over sternotomy
topic myxoma
median sternotomy
minimal invasive cardiac surgery
right anterolateral mini-thoracotomy
url https://jctm.mums.ac.ir/article_17798_e3ddc20a63c2ec8d06057bf4a38f3630.pdf
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