Thorac cardiovasc Surg 2018; 66(02): 193-197
DOI: 10.1055/s-0036-1584269
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Right Anterolateral Minithoracotomy versus Median Sternotomy Approach for Resection of Left Atrial Myxoma

Nian Guo Dong
1  Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
,
Kai Lun Zhang
1  Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
,
Long Wu
1  Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
,
Hao Hong
1  Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
› Author Affiliations
Funding This work was supported by grants from the National Natural Science Foundation of China (grand number 81300174, 31330029) and Research Fund for the Doctoral Program of Higher Education of China (fund number 20120142120078).
Further Information

Publication History

21 March 2016

22 April 2016

Publication Date:
08 June 2016 (eFirst)

Abstract

Background Minimally invasive surgery has become the standard approach for several cardiac diseases. In this retrospective study, we compared right anterolateral minithoracotomy (RALT) with standard median sternotomy (SMS) for resection of left atrial myxoma (LAM).

Materials and Methods From January 2009 to June 2015, the clinical data of patients who underwent RALT (n = 30) and SMS (n = 36) for resection of LAM in our hospital were collected. The preoperative clinical data and operative results were compared between the two groups.

Results There were no significant differences in aortic cross-clamp and cardiopulmonary bypass time between the two groups. The total incision length was significantly shorter in RALT group compared with SMS group (p < 0.001). For RALT and SMS groups, respectively, the intensive care unit length of stay was 29.2 ± 6.5 versus 43.5 ± 6.9 hours (p < 0.001), and the postoperative hospital length of stay was 5 days (interquartile range [IQR]: 4–6) versus 8 days (IQR: 7–10) (p < 0.001). The total cost in RALT group was 27,000 RMB (IQR: 25,000–29,000) versus 33,000 RMB (IQR: 31,000–35,000) in SMS group (p < 0.001). There were no significant differences in mortality and postoperative complications between the two groups.

Conclusion RALT approach for LAM resection can be performed safely with favorable cosmetic outcome, accepted clinical results, and lower cost. It should be considered as a promising alternative to SMS and merit additional study.