Resection of Left Atrial Myxoma in a Patient with Retrosternal Gastric Tube: a Case Report

Abstract

The median sternotomy remains the standard approach in cardiovascular surgery but, in some conditions, it can be considered difficult to perform, especially in patients with history of esophagectomy. This case report describes a successful resection of a left atrial myxoma through a right anterolateral thoracotomy approach in a patient with a previous retrosternal gastric tube reconstruction. The decision for the best surgical approach was made after a heart surgery team discussion. Through this surgical access, a safe and excellent exposure of the left atrium was possible, and a complete resection of the myxoma was performed without any injury to the gastric tube.

Mitral valve repair for a patient with presternal esophageal reconstruction

“…A right thoracotomy is effective for mitral valve surgery because it allows an approach to the mitral and tricuspid valves without touching the presternal GT. 1,2 However, it has some disadvantages such as dissection of adhesions in the tight thoracic cavity and insufficient working space for precise mitral valve repair. In addition, evaluation after mitral valve repair is insufficient because transesophageal and epicardial echocardiography cannot be used.…”