title: Extended vertical transatrial septal approach for the removal of left atrial myxoma.
abstract: OBJECTIVE
  Optimal exposure greatly facilitates left atrial myxomectomy and is mandatory for safe and efficacious tumour removal. The purpose of this study was to evaluate one institutions experience, with an alternative to the classical approach, for the removal of left atrial myxoma.
  
  
  METHODS
  In an eight-year period, eight patients underwent surgical removal of left atrial myxoma at our institution using the extended vertical transatrial septal approach, slightly modified compared to the original method of Guiraudon and associates, as the septum was initially incised superiorly instead of through the fossa ovalis.
  
  
  RESULTS
  One patient with poor left ventricular function died shortly after the surgical procedure because of low cardiac output. Postoperative course of the other patients was uneventful. No rethoracotomy for bleeding was carried out and no permanent arrhythmias were seen. There was one late death at 4.5 months after operation, for which no clear reason was found. Mean follow-up was 55 months (range 1 to 79 months) and revealed six asymptomatic healthy patients.
  
  
  CONCLUSIONS
  We feel that the extended vertical transatrial septal approach provides good exposure of left atrial tumours and facilitates complete surgical removal without inherent complications such as tumour cell dissemination or fragmentation.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: C J
authors.initials: CJ
authors.lastname: Zeebregts
authors.forename: M A
authors.initials: MA
authors.lastname: Schepens
authors.forename: P J
authors.initials: PJ
authors.lastname: Knaepen
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery; D006338:Heart Neoplasms / Q000401:mortality / Q000601:surgery*; D006346:Heart Septum / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome