Superior transseptal approach to left atrial myxomas

Viganò, M; Grande, Antonino M.; Gaeta, Roberto

doi:10.1016/0003-4975(96)81285-9

Cited by 7 publications

(6 citation statements)

References 3 publications

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“…Vigano et al reported the efficacy of the superior septal approach for resection of left atrial myxomas. 4 To our knowledge, there has been no report of a BM resected via the SSA. The surgical view obtained by a biatrial or transseptal approach alone is not enough for resection of a giant BM, such as in our case.…”

Section: Discussionmentioning

confidence: 94%

“…SSA does carry the risk of postoperative arrhythmia because of division of both the sinus node artery and internodal pathway, 5,6 whereas SSA offers excellent surgical exposure of both the right and left atria simultaneously. [4][5][6][7] In the present case, SSA was chosen because we believe that resectability should be given priority over postoperative dysrhythmia. Therefore, we also placed an epicardial pacing lead onto the right ventricle.…”

Section: Discussionmentioning

confidence: 99%

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Intraseptal biatrial myxoma excised via the superior septal approach

Totsugawa

Kurabayashi

Nishigawa

et al. 2008

Gen Thorac Cardiovasc Surg

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A 72-year-old man suffering from exertional dyspnea was admitted to our hospital. A computed tomography scan revealed a huge tumor occupying the interatrial septum and growing toward both the right and left atria. The tumor was successfully excised via the superior septal approach. Histological examination of the surgical specimen revealed that it was a myxoma. The patient recovered uneventfully and was discharged from our hospital 28 days after surgery. He received a permanent pacemaker implant due to sick sinus syndrome 12 months after surgery. To our knowledge, this is the first report of resection of intraseptal biatrial myxoma.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Intraseptal biatrial myxoma excised via the superior septal approach

Totsugawa

Kurabayashi

Nishigawa

et al. 2008

Gen Thorac Cardiovasc Surg

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“…Guiraudon replied that he had used this approach in two patients with left atrial myxoma and in 1995, Viganò added another four patients [11]. To our knowledge, no reports on this issue have appeared hereafter.…”

Section: Discussionmentioning

confidence: 99%

Extended vertical transatrial septal approach for the removal of left atrial myxoma

Zeebregts

Schepens

Knaepen

1998

European Journal of Cardio-Thoracic Surgery

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Objective: Optimal exposure greatly facilitates left atrial myxomectomy and is mandatory for safe and efficacious tumour removal. The purpose of this study was to evaluate one institutions experience, with an alternative to the classical approach, for the removal of left atrial myxoma. Methods: In an eight-year period, eight patients underwent surgical removal of left atrial myxoma at our institution using the extended vertical transatrial septal approach, slightly modified compared to the original method of Guiraudon and associates, as the septum was initially incised superiorly instead of through the fossa ovalis. Results: One patient with poor left ventricular function died shortly after the surgical procedure because of low cardiac output. Postoperative course of the other patients was uneventful. No rethoracotomy for bleeding was carried out and no permanent arrhythmias were seen. There was one late death at 4.5 months after operation, for which no clear reason was found. Mean follow-up was 55 months (range 1 to 79 months) and revealed six asymptomatic healthy patients. Conclusions: We feel that the extended vertical transatrial septal approach provides good exposure of left atrial tumours and facilitates complete surgical removal without inherent complications such as tumour cell dissemination or fragmentation.

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“…The left atrium can be inspected, and the myxoma with its implant site can be easily removed. 6 If the removal of the tumor leaves a lack of atrial septum, a pericardial patch can be used. Atriotomy is closed using two 4-0 running polypropylene sutures starting at each end, closing the left atrial incision.…”

Section: Methodsmentioning

confidence: 99%

Superior Transseptal Approach for Surgical Removal of Left Atrial Myxoma

et al. 1997

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Eight patients (4 men, 4 women), mean age 51 years, referred to our Institution for left atrial myxoma underwent removal of the tumor through a superior transseptal approach. All patients in sinus rhythm with normal conduction time. The myxomas were localized in the fossa ovalis (3 cases), interatrial septum (2 cases), left appendage (2 cases), and mitral annulus (1 case). One patient died in hospital after emergency operation for low-output syndrome complicated by septic shock. All other patients had an uneventful postoperative course. Atrial arrhythmias did not represent a major postoperative complication. Transient PR interval elongation was occasionally seen. Electrophysiological studies showed normal sinus node function. At 6 months following operation, patients were evaluated with transesophageal echocardiography. There was no tumor recurrence. There were no episodes of arrhythmia in 24-hour electrocardiographic monitoring, and all patients were in NYHA Class I. We believe that the superior transseptal approach gives optimal exposure of the left atrial cavity, overcoming all difficulties related to a small left atrium which is an usual pattern in left atrial myxomas.

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Superior transseptal approach to left atrial myxomas

Cited by 7 publications

References 3 publications

Intraseptal biatrial myxoma excised via the superior septal approach

Intraseptal biatrial myxoma excised via the superior septal approach

Extended vertical transatrial septal approach for the removal of left atrial myxoma

Superior Transseptal Approach for Surgical Removal of Left Atrial Myxoma

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