Korean J Thorac Cardiovasc Surg.  2016 Oct;49(5):356-360. 10.5090/kjtcs.2016.49.5.356.

Surgical Outcomes of Cardiac Myxoma: Right Minithoracotomy Approach versus Median Sternotomy Approach

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea. ctsjungsh@hanmail.net
  • 2Department of Thoracic and Cardiovascular Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Korea.

Abstract

BACKGROUND
The standard approach in treating cardiac myxoma is the median full sternotomy. With the evolution of surgical techniques, the right minithoracotomy approach has emerged as an alternative method. Since few studies have been published assessing the right minithoracotomy approach, we performed a retrospective study to compare the clinical outcomes of the right minithoracotomy approach with those of the sternotomy approach.
METHODS
From January 2005 to December 2014, 203 patients underwent resection of a cardiac myxoma. Patients with preexisting cardiac problems were excluded from this study. 146 patients were enrolled in this study; 83 patients were treated using a median sternotomy and 63 patients were treated using a right minithoracotomy.
RESULTS
No early mortalities were recorded in either group. Although the cardiopulmonary bypass time and aorta cross-clamp time were significantly shorter in the sternotomy group (p<0.001 and p=0.005), postoperative blood transfusions and arrhythmia events were significantly less common in the thoracotomy group (p=0.004 and p=0.025, respectively). No significant differences were found in the duration of the hospital stay, postoperative intubation time, the duration of the intensive care unit stay, and recurrence.
CONCLUSION
The minimally invasive right minithoracotomy approach is a good alternative method for treating cardiac myxoma because it was found to be associated with a lower incidence of postoperative complications and a shorter postoperative recovery period.

Keyword

Myxoma; Minimally invasive surgery; Tumor, benign

MeSH Terms

Aorta
Arrhythmias, Cardiac
Blood Transfusion
Cardiopulmonary Bypass
Humans
Incidence
Intensive Care Units
Intubation
Length of Stay
Methods
Minimally Invasive Surgical Procedures
Mortality
Myxoma*
Postoperative Complications
Recurrence
Retrospective Studies
Sternotomy*
Thoracotomy
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