Management of a Heart Myxoma Through a Right Thoracotomy in a Patient With a Previous Sternotomy

Abstract

Myxoma is the most common benign cardiac tumor, presenting most frequently in the left atrium. Median sternotomy has been traditionally used to provide access to the heart and the mediastinal structures in cardiac operations. Recently, right thoracotomy and minithoracotomy have been used as an alternative. We present a case of a patient with left atrial myxoma, who had been subjected to coronary artery bypass graft 2 years ago. The previous full median sternotomy urged the need for another approach. A right lateral thoracotomy with one lung ventilation was chosen, offering excellent access to the heart and mediastinum. The patient was set under cardiopulmonary bypass and cardioplegia and the mass was excised through a left atrial incision. The perioperative course was free of complications. We suggest that right thoracotomy is a safe and efficient way of treating cardiac tumors in selected patients, when median sternotomy is considered complicated, not possible or contraindicated. J Med Cases. 2016;7(2):52-53 doi: http://dx.doi.org/10.14740/jmc2405w