title: Transaortic video-assisted resection of a recurrent left ventricular myxoma.
abstract: An asymptomatic 57-year-old woman presented for resection of a fifth cardiac myxoma. To avoid complete redissection of the heart, we proposed a video-assisted transaortic approach for a recurrent left ventricle (LV) myxoma resection. In a hybrid approach, sternotomy and open aortotomy provided the minimally invasive transaortic access to the myxoma. The myxoma was discovered during a routine echocardiographic screening. A 30° 5-mm scope, video-assisted thoracic surgery graspers, and endoshears were used for resection. The video-assisted technique significantly enhanced the intracardiac visualization, and a smaller, second myxoma was discovered after resection of the primary lesion. Both myxoma beds were additionally ablated to prevent recurrence. The total video-assisted operating time was 58 minutes. The transaortic valve approach avoided an atriotomy or ventriculotomy in a fifth redo operation. A transaortic valve approach to LV intracardiac lesions is safe and feasible, and it provides excellent visibility for complex cardiac cases.
authors.affiliation: Division of Thoracic and Esophageal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio 44106-5011, USA. carsten.schroeder@uhhospitals.org
authors.forename: Carsten
authors.initials: C
authors.lastname: Schröder
authors.forename: William H
authors.initials: WH
authors.lastname: Leukhardt
authors.forename: Edward M C
authors.initials: EM
authors.lastname: Hsiao
authors.forename: Michel G
authors.initials: MG
authors.lastname: Farah
authors.forename: Alan H
authors.initials: AH
authors.lastname: Markowitz
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D005260:Female; D006338:Heart Neoplasms / Q000175:diagnosis / Q000601:surgery*; D006352:Heart Ventricles; D006801:Humans; D008875:Middle Aged; D009232:Myxoma / Q000175:diagnosis / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed