Minithoracotomy for the excision of cardiac myxoma: A comparative study of a Latin American experience

Ríos-Ortega J.C.; Sisniegas-Razón J.; Díaz-Chávez Z.; Espinoza-Alva D.; Aguilar-Carranza C.; Pérez-Valverde Y.; Morón-Castro J. · Cirugia Cardiovascular (2025) · DOI: 10.1016/j.circv.2025.09.001

Resumen

Introduction and objectives: Traditionally, full sternotomy (FS) has been the gold standard for cardiac myxoma resection, however, in the last decade, minimally invasive surgery has become an attractive surgical alternative. The objective of this study is to compare the postoperative results of cardiac myxoma resection by minithoracotomy (MT) versus standard FS in a national referral center. Methods: From January 2010 to December 2023, 85 patients with diagnosis of cardiac myxoma underwent surgery by FS or MT in our hospital. We compared perioperative and follow-up mortality and major complications, and other clinical variables. Results: We compared 65 patients who underwent FS versus 20 who underwent MT for cardiac myxoma excision, all cases with histopathological confirmation. Mortality at 30 days was 1/65 (1.5%) for FS versus 0/20 (0%) for MT (p:0.58). The cardiopulmonary bypass (CPB) time (73min IQR: 53–86 vs 65.5 IQR: 59–72, p: 0.18) were similar, but aortic cross clamp (ACC) time (51min IQR: 26–67 vs 30.5 IQR: 24–35.5, p: 0.02) was shorter in MT. Patients underwent MT had less intraoperative (420ml IQR: 360–500 vs 275 IQR: 200–475, p<0.01) and postoperative bleeding (400ml IQR: 350–460 vs 220 IQR: 185–275, p<0.01) than those who underwent FS. The intensive care unit (ICU) stay was significantly shorter in MT group (3 days, IQR: 2–3 versus 2 days IQR: 1–2, p<0.01). Conclusions: MT for cardiac myxoma excision is a safe procedure and it has less intraoperative and postoperative bleeding compared to FS, as well as fewer days of ICU stay.