Minimal invasive surgery for intracardiac tumors – report of 19 consecutive patients

Background: Based on our experience in minimal invasive mitral and tricuspid valve surgery, we applied this technique for the resection of benign intracardiac tumors.

Methods: We prospectively evaluate all patients with cardiac tumors. From April 2006 until August 2009, we performed 232 less invasive surgical procedures through a right lateral mini-thoracotomy using femoral canulation for cardiopulmonary bypass, of these19 patients underwent minimal invasive cardiac tumor resection. Eight patients (42%) were male and mean age was 60 (range 27 to 79 years). Transesophageal echocardiography was used in all cases to confirm the cardiac mass and for the guidance and position control of the venous cannula.

Results: Mean duration of cardiopulmonary bypass and crossclamp times was 91min (range 37 to 167min) and 44min (range 0 to 77min), respectively. Primary mean intubation time was 8 hours (range 4 to 11 hours). Histologic investigation revealed 14 cardiac myxomas, 2 papillary fibroelastomas and 2 thrombi. All tumors were removed completely. There were no deaths, no bleeding, no wound or vascular complications. The mean postoperative length of stay on ICU and in hospital was 13 hours (range 7 to 21 hours) and 9 days (range 4 to 12 days), respectively. Follow up ranged from 1 to 36 months (mean 17 months). No recurrences have been observed so far.

Conclusion: Minimal invasive resection of cardiac tumors is technically feasible and can be applied with good functional and favorable cosmetic results.