초록접수 현황
| 20F-218 | 구연 발표 |
Surgical outcomes of cardiac myxoma resection through right mini-thoracotomy
Hyung Gon Je, Min ho Ju, Chee-hoon Lee, Mi Hee Lim, Ji Hye Lee
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Medical Research Institute of Pusan National University, Yangsan, South Korea
Purpose : With the recent advance in cardiac surgery through minimal access, the mini-thoracotomy approach has emerged as an excellent alternative to resect cardiac myxoma. In this study, we aimed to analyze our surgical results of this approach focused on postoperative cerebral embolism and the tumor recurrence.
Methods : From October 2008 to July 2020, we retrospectively reviewed 60 patients (mean age 56.0±12.1 years, 40 females). We conducted femoral cannulation and antegrade cardioplegic arrest in all patients. The patients’ characteristics and the perioperative data, including brain diffusion-weighted magnetic resonance image (DWI) were collected. Follow-up echocardiograpram was obtained annually.
Results : 12 (20.0%) patients had a history of preoperative stroke, and 7 (11.7%) patients had dyspnea with NYHA functional class III or IV. All myxomas were located in the left atrium and the mean diameter was 3.5±1.5cm. Mean cardiopulmonary bypass and cardiac ischemic times were 70.2±28.9 and 34.2±15.3 minutes, respectively. There was no sternotomy conversion, and 46 (77%) patients were extubated in the operating room. Mean intensive care unit and hospital stay were 28.0±20.9 hours and 5.0±2.6 days, respectively. There was no early mortality, with no postoperative stroke. The postoperative DWI was checked in 32 (53%) patients, and 7 (22%) silent cerebral embolisms were detected. During mean 13.9±18.8 months of follow-up duration, no tumor recurrence was detected.
Conclusion : The mini-thoracotomy approach for cardiac myxoma resection showed acceptable surgical and neurologic outcomes. In midterm echocardiographic follow-up, reliable resection was proven with no recurrence. It can be a promising alternative surgical method for cardiac myxoma resection.
Methods : From October 2008 to July 2020, we retrospectively reviewed 60 patients (mean age 56.0±12.1 years, 40 females). We conducted femoral cannulation and antegrade cardioplegic arrest in all patients. The patients’ characteristics and the perioperative data, including brain diffusion-weighted magnetic resonance image (DWI) were collected. Follow-up echocardiograpram was obtained annually.
Results : 12 (20.0%) patients had a history of preoperative stroke, and 7 (11.7%) patients had dyspnea with NYHA functional class III or IV. All myxomas were located in the left atrium and the mean diameter was 3.5±1.5cm. Mean cardiopulmonary bypass and cardiac ischemic times were 70.2±28.9 and 34.2±15.3 minutes, respectively. There was no sternotomy conversion, and 46 (77%) patients were extubated in the operating room. Mean intensive care unit and hospital stay were 28.0±20.9 hours and 5.0±2.6 days, respectively. There was no early mortality, with no postoperative stroke. The postoperative DWI was checked in 32 (53%) patients, and 7 (22%) silent cerebral embolisms were detected. During mean 13.9±18.8 months of follow-up duration, no tumor recurrence was detected.
Conclusion : The mini-thoracotomy approach for cardiac myxoma resection showed acceptable surgical and neurologic outcomes. In midterm echocardiographic follow-up, reliable resection was proven with no recurrence. It can be a promising alternative surgical method for cardiac myxoma resection.
책임저자: Hyung Gon Je
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital (PNUYH), Medical Research Institute of Pusan National University, Yangsan-si, South Korea
발표자: Chang Won Shin, E-mail : s.c.w910926@gmail.com