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Minimally invasive resection of atrial tumors via mini antero-lateral thoracotomy
Anke-Susann Sprengel, Mirko Doss, Ayse Cetinkaya, Schönburg Markus, Thomas Walther.
Kerckhoff-Klinik Bad Nauheim, Bad Nauheim, Germany.

OBJECTIVE: Reports of minimally invasive treatment of atrial tumors are rare. We present our single-center experience with minimally invasive resection of left- and right atrial tumors.
METHODS: From June 2009 minimally invasive resection of atrial tumors was performed in 34 patients (9 male) via a right mini-thoracotomy. Tumor location was left-atrial in 28 and right-atrial in 6 patients. Surgical access was performed via left-atrial approach in 18 patients, right-atrial in 6 patients and trans-septal in 10 patients.
RESULTS: There was no operative mortality. Mean age at the time of operation was 61 years (range 40-80 years). Mean CPB-time was 98+- 26 min.(median 98 min.). Cross clamp time was 52+-16 min.(median 55 min.) respectively. Five patients were operated with induced fibrillation. There were no conversions to open sternotomy. Fourteen patients required closure of an atrial septal defect (patch closure in 11). Histologic examination showed typical atrial myxoma (n=31), endocardial haemangioma (n=1), papillary elastoma of the tricuspid valve (n=1) and malignant melanoma (n=1). No postoperative neurological impairment was observed in any patient. Two patients reqired femoral access site revision due to seroma.
CONCLUSIONS: Minimal invasive resection of left- and right atrial tumors is feasible with excellent clinical outcomes. Major neurologic complications are rare and patient acceptance is high.

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