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.
Highlights
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 (RGT) reconstruction for adenocarcinoma of esophagogastric junction
A 66-year-old male, physician, was admitted to our institute with a left atrial tumor suggesting a myxoma. He had a history of esophagectomy with retrosternal gastric tube reconstruction for adenocarcinoma of gastroesophageal junction, twenty years previously
Summary
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. Cardiac surgery is still uncommon after an esophagectomy, due to the poor prognosis of esophageal cancer 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 (RGT) reconstruction for adenocarcinoma of esophagogastric junction. A 66-year-old male, physician, was admitted to our institute with a left atrial tumor suggesting a myxoma He had a history of esophagectomy with retrosternal gastric tube reconstruction for adenocarcinoma of gastroesophageal junction, twenty years previously. He was asymptomatic, and the left atrial mass was incidentally discovered by an echocardiogram study during a preoperative evaluation for an ophthalmologic procedure. After nineteen months of follow-up, medical surveillance shows no complication (Table 1)
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