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International Society For Minimally Invasive Cardiothoracic Surgery

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Totally Thoracoscopic Excision of Left Atrial Myxoma
Ikromzhon Mukhamedov, Seitkhan Joshibayev, Kristina Kapussidi
Research-Clinical Center for Cardiac Surgery and Transplantology, Taraz, Kazakhstan

BACKGROUND: We present our first experience of totally thoracoscopic excision of left atrial myxoma using the three ports access technique
METHODS: Two patients with left atrial myxoma were treated, which were 1 woman and 1 man. The average age of the patients was 47 years, the average weight was 72 kg. Three ports are located on the right side of the chest, while the aorta was clamped transthoracically and myocardial protection achieved with antegrade cardioplegia. As usual in this technique peripheral cardiopulmonary bypass was used
RESULTS: Both surgeries were successful, with no hospital deaths and no brain damage. The dimensions the left atrial myxoma in the first patient were 4 6 cm, in the second - 3 5 cm. After excision of the myxoma, the inter-atrial septum was closed with autopericardial patch. The average duration of cardiopulmonary bypass was 249.6 26.3 minutes, aortic clamping time was 80 14.8, length of stay in the intensive care unit was 16.7 2.2 hours, mechanical ventilation time was 131.2 78,6 minutes, while length of postoperative hospital stay was 8.1 1.5 days. After 72 hours, one patient had atrial flutter, however after treatment with antiarrhythmic drugs, the sinus rhythm was restored. Transthoracic echocardiography results were satisfactory before discharge
CONCLUSIONS:Totally thoracoscopic excision of left atrial myxoma was feasible and safe. Nevertheless the obtained results, a long term follow-up is needed


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