The clinical application of minimally invasive technique in surgical treatment of cardiac tumors_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SONG Kai , SHEN Jinqiang , WEI Lai , XIA Limin , DING Wenjun , SUN Yongxin , LAI Hao ,  WANG Chunsheng

Department of Cardiovascular Surgery, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R.China;

Corresponding author：

WANG Chunsheng, Email: wang.chunsheng@zs-hospital.sh.cn

Keywords：

Minimally invasive; cardiac tumors; surgery

DOI：

10.7507/1007-4848.201509065

Video：

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Objective To share clinical experience of minimally invasive technique in surgical treatment of cardiac tumors. Methods Clinical data of 50 patients with cardiac tumors who underwent surgical teatment in Zhongshan Hospital of Fudan University from January 2011 to September 2014 were analyzed retrospectively. There were 18 males and 32 females aged from 32 to 65 years (mean age 47 years). Cardiac tumors were located in the left atrium in 44 (88%) patients and right atrium in 6 (12%) patients. Results There was no in-hospital death. All patients recovered well without any complications. Mean total operating, cardiopulmonary bypass and aortic cross-clamp time was 148±45 min, 56±23 min, 26±16 min, respectively. The average time to extubation was 5±3 hours and the median length of stay in the intensive care unit (ICU) and in the hospital was 9±6 hours and 5±3 days, respectively. All patients were followed up for 1 to 44 months without tumor recurrence except one. Conclusion Minimally invasive technique in surgical treatment of cardiac tumors via right anterolateral thoracotomy is a safe and feasible method with good cosmetic results and rapid postoperative recovery, and is worthy of clinical selective application for treatment of benign cardiac tumor.

Citation： SONG Kai, SHEN Jinqiang, WEI Lai, XIA Limin, DING Wenjun, SUN Yongxin, LAI Hao, WANG Chunsheng. The clinical application of minimally invasive technique in surgical treatment of cardiac tumors. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(8): 626-629. doi: 10.7507/1007-4848.201509065 Copy

1.	李平, 尤斌, 高峰, 等. 直视微创心脏外科手术临床应用 108 例. 中华胸心血管外科杂志, 2012, 28(5): 289-293.
2.	Aristotelis P, Patrick OM. Video-assisted cardiac myxoma resection: basket technique for complete and safe removal from the heart. Ann Thorac Surg, 2012, 93(11): e109-e110.
3.	Po JK, Chau HC, Pyng JL, et al. Video-assisted minimal access in excision of left atrial myxoma. Ann Thorac Surg, 1998, 66(5): 1301-1305.
4.	Andrea G, Giovanni N, Alberto C, et al. Surgical excision of cardiac myxomas: twenty years experience at a single institution. Ann Thorac Surg, 2012, 93(11): 825-831.
5.	Yu S, Xu X, Zhao B, et al. Totally thoracoscopic surgical resection of cardiac myxoma in 12 patients. Ann Thorac Surg, 2010, 90(9): 674-676.
6.	Nordstrand IA, Tam RK. Minimally invasive surgery for cardiac myxomas using an upper hemi-sternotomy and biatrialseptal approach. Heart Lung Circ, 2005, 14(4): 255-261.
7.	Butany J, Nair V, Naseemuddin A, et al. Cardiac tumors: diagnosis and management. Lancet Oncol, 2005, 6(4):219-228.
8.	胡盛寿, 王小啟, 许建屏, 等. 心脏肿瘤外科治疗经验总结. 中华医学杂志, 2006, 86(11): 766-770.
9.	Dogan S, Aybek T, Risteski PS, et al. Minimally invasive port access versus conventional mitral valve surgery: a prospective randomized study. Ann Thorac Surg, 2005, 79(6): 492-498.
10.	Michele M, Antonio M, Gioia DS, et al. Minimally invasive right thoracotomy approach for mitral valve surgery in patients with previous sternotomy: A single institution experience with 173 patients. J Thorac Cardiovasc Surg, 2014, 148(12): 2763-2768.
11.	Borger MA, Kaeding AF, Seeburger J, et al. Minimally invasive mitral valve repair in Barlow’s disease: Early and long-term results. J Thorac Cardiovasc Surg. 2014, 148(4): 1379-1385.
12.	Paul M, Ansar H, Chitwood WR. Minimally invasive mitral valve surgery: a systematic review and meta-analysis. Eur J Cardiothorac Surg, 2008, 34(8): 943-952.
13.	Wang DJ, Wang Q, Yang XB, et al. Mitral valve replacement through a minimal right vertical infra-axillary thoracotomy versus standard median sternotomy. Ann Thorac Surg, 2009, 87(8): 704-708.
14.	Cohn LH, Adastandard DH, Couper GS, et al. Minimally invasive cardiac valve surgery improves patient satisfaction while reducing costs of cardiac valve replacement and repair. Ann Thorac Surg, 1997, 226(6): 421-428.
15.	魏来, 王春生, 沈金强, 等. Chitwood 法微创心脏瓣膜手术 115 例临床分析. 中华外科杂志, 2011, 49(9): 373-375.
16.	Leopoldo P, Castro R, Zamorano J, et al. Diagnosis and treatment of cardiac myxomas by transesophageal echocardiography. Am J Cardiol, 2002, 90(9): 1419-1421.
17.	Pinedaa A, Santana O, Bergoderib M, et al. Is a minimally invasive approach for resection of benign cardiac masses superior to standard full sternotomy? Interact CardioVasc Thorac Surg, 2013, 16(12): 875-879.
18.	Hoey ETD, Mankad K, Puppala S, et al. MRI and CT appearances of cardiac tumours in adults. Clin Radiol, 2009, 64(7): 1214-1230.
19.	沈金强, 魏来, 夏利民, 等. 微创主动脉瓣置换手术 101 例临床分析. 中华外科杂志, 2013, 51(3): 252-255.
20.	周荻, 罗红. 微创心脏手术建立体外循环时经皮上腔静脉插管技术. 中华麻醉学杂志, 2011, 31(6): 1500.

1. 李平, 尤斌, 高峰, 等. 直视微创心脏外科手术临床应用 108 例. 中华胸心血管外科杂志, 2012, 28(5): 289-293.
2. Aristotelis P, Patrick OM. Video-assisted cardiac myxoma resection: basket technique for complete and safe removal from the heart. Ann Thorac Surg, 2012, 93(11): e109-e110.
3. Po JK, Chau HC, Pyng JL, et al. Video-assisted minimal access in excision of left atrial myxoma. Ann Thorac Surg, 1998, 66(5): 1301-1305.
4. Andrea G, Giovanni N, Alberto C, et al. Surgical excision of cardiac myxomas: twenty years experience at a single institution. Ann Thorac Surg, 2012, 93(11): 825-831.
5. Yu S, Xu X, Zhao B, et al. Totally thoracoscopic surgical resection of cardiac myxoma in 12 patients. Ann Thorac Surg, 2010, 90(9): 674-676.
6. Nordstrand IA, Tam RK. Minimally invasive surgery for cardiac myxomas using an upper hemi-sternotomy and biatrialseptal approach. Heart Lung Circ, 2005, 14(4): 255-261.
7. Butany J, Nair V, Naseemuddin A, et al. Cardiac tumors: diagnosis and management. Lancet Oncol, 2005, 6(4):219-228.
8. 胡盛寿, 王小啟, 许建屏, 等. 心脏肿瘤外科治疗经验总结. 中华医学杂志, 2006, 86(11): 766-770.
9. Dogan S, Aybek T, Risteski PS, et al. Minimally invasive port access versus conventional mitral valve surgery: a prospective randomized study. Ann Thorac Surg, 2005, 79(6): 492-498.
10. Michele M, Antonio M, Gioia DS, et al. Minimally invasive right thoracotomy approach for mitral valve surgery in patients with previous sternotomy: A single institution experience with 173 patients. J Thorac Cardiovasc Surg, 2014, 148(12): 2763-2768.
11. Borger MA, Kaeding AF, Seeburger J, et al. Minimally invasive mitral valve repair in Barlow’s disease: Early and long-term results. J Thorac Cardiovasc Surg. 2014, 148(4): 1379-1385.
12. Paul M, Ansar H, Chitwood WR. Minimally invasive mitral valve surgery: a systematic review and meta-analysis. Eur J Cardiothorac Surg, 2008, 34(8): 943-952.
13. Wang DJ, Wang Q, Yang XB, et al. Mitral valve replacement through a minimal right vertical infra-axillary thoracotomy versus standard median sternotomy. Ann Thorac Surg, 2009, 87(8): 704-708.
14. Cohn LH, Adastandard DH, Couper GS, et al. Minimally invasive cardiac valve surgery improves patient satisfaction while reducing costs of cardiac valve replacement and repair. Ann Thorac Surg, 1997, 226(6): 421-428.
15. 魏来, 王春生, 沈金强, 等. Chitwood 法微创心脏瓣膜手术 115 例临床分析. 中华外科杂志, 2011, 49(9): 373-375.
16. Leopoldo P, Castro R, Zamorano J, et al. Diagnosis and treatment of cardiac myxomas by transesophageal echocardiography. Am J Cardiol, 2002, 90(9): 1419-1421.
17. Pinedaa A, Santana O, Bergoderib M, et al. Is a minimally invasive approach for resection of benign cardiac masses superior to standard full sternotomy? Interact CardioVasc Thorac Surg, 2013, 16(12): 875-879.
18. Hoey ETD, Mankad K, Puppala S, et al. MRI and CT appearances of cardiac tumours in adults. Clin Radiol, 2009, 64(7): 1214-1230.
19. 沈金强, 魏来, 夏利民, 等. 微创主动脉瓣置换手术 101 例临床分析. 中华外科杂志, 2013, 51(3): 252-255.
20. 周荻, 罗红. 微创心脏手术建立体外循环时经皮上腔静脉插管技术. 中华麻醉学杂志, 2011, 31(6): 1500.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The clinical application of minimally invasive technique in surgical treatment of cardiac tumors

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