Intraoperative trans-mitral endoscopic resection of left ventricular tumor

Kudo, Mikihiko; Misumi, Takahiko; Koizumi, Kiyoshi; Suzuki, Takaaki; Nakagawa, Motohito

doi:10.1007/s11748-004-0049-4

Cited by 5 publications

(8 citation statements)

References 5 publications

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“…This was followed by semi-rigid endoscopes in four [7, 9, 21, 29], flexible endoscopes in three [2, 3, 30] and mixture of rigid and flexible endoscopes in one study [11]. In 13 studies, the type of endoscope used was not specified [4, 6, 10, 15, 20, 24–28, 31, 34, 35].…”

Section: Resultsmentioning

confidence: 99%

“…In 13 studies, the type of endoscope used was not specified [4, 6, 10, 15, 20, 24–28, 31, 34, 35]. Other adjunct endoscopic instruments such as forceps, graspers, scissors, suckers or retractors were used in 13 studies [2, 3, 12, 13, 15, 19, 21, 25, 30, 32, 34, 35, 37]. In the remaining it was not clear whether open surgical or endoscopic instruments were used.…”

Section: Resultsmentioning

confidence: 99%

“…In the remaining it was not clear whether open surgical or endoscopic instruments were used. The pre-operative imaging was pre-dominantly echocardiography, noted in 31 cases [2–10, 12–15, 20–37]. In one case ventriculography was used [19] and in the remaining 22 cases the imaging method was not specified [1, 11].…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of left ventricular cardio-endoscopic surgery

Soylu

Kidher

Ashrafian

et al. 2017

J Cardiothorac Surg

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Better visualisation, accurate resection and avoidance of ventriculotomy associated with use of endoscopic devices during intracardiac surgery has led to increasing interest in their use. The possibility of combining a cardio-endoscopic technique with either minimally invasive or totally endoscopic cardiac surgery provides an incentive for its further development. Several devices have been used, however their uptake has been limited due to uncertainty around their impact on patient outcomes. A systematic review of the literature identified 34 studies, incorporating 54 subjects undergoing treatment of left ventricular tumours, thrombus or hypertrophic myocardium using a cardio-endoscopic technique. There were no mortalities (0%; 0/47). In 12 studies, the follow-up period was longer than 30 days. There were no post-operative complications apart from one case of atrial fibrillation (2.2%; 1/46). Complete resection of left ventricular lesion was achieved in all cases (100%; 50/50). These successful results demonstrate that the cardio-endoscopic technique is a useful adjunct in resection of left ventricular tumours, thrombus and hypertrophic myocardium. This approach facilitates accurate resection of pathological tissue from left ventricle whilst avoiding exposure related valvular damage and adverse effects associated with ventriculotomy. Future research should focus on designing adequately powered comparative randomised trials focusing on major cardiac and cerebrovascular morbidity outcomes in both the short and long-term. In this way, we may have a more comprehensive picture of both the safety and efficacy of this technique and determine whether such devices could be safely adopted for routine use in minimal access or robotic intra-cardiac surgery.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-017-0599-z) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A systematic review of left ventricular cardio-endoscopic surgery

Soylu

Kidher

Ashrafian

et al. 2017

J Cardiothorac Surg

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“…Kudo et al reported an intraoperative transmitral endoscopic resection of a left ventricular tumor. 3 Misumi et al reported two cases of endoscopic resection of left ventricular tumors through the mitral valve and the aortic valve. 4 Li et al reported a technique using video-assisted cardioscopy to remove a left ventricular myxoma.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative bronchoscopic resection of a papillary fibroelastoma in the left ventricular outflow tract after aortic mechanical valve replacement

Shuto

Miyamoto

Anai

et al. 2010

Gen Thorac Cardiovasc Surg

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We report the case of an 80-year-old man who 11 years previously had undergone aortic valve replacement (St. Jude Medical mechanical heart valve 23 mm) because of aortic stenosis. At the current presentation, a 7-mm pedunculated tumor was discovered along the septal wall in the left ventricular outflow tract. In an attempt to perform a less invasive procedure because of the patient's advanced age, transaortic valve bronchoscopic resection was undertaken. A bronchoscope (Olympus BF P-200) was fed through a gap in the mechanical aortic valve. The entire tumor was removed using biopsy forceps, with histology revealing a papillary fibroelastoma. By using a bronchoscope, we avoided a second valve replacement.

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“…We have already reported the first case of an endoscopic transmitral resection of a left ventricular papillary fibroelastoma. 1 In this paper, we describe this technique in detail. revealed all bypass grafts to be patent.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Endoscopic Resection of Left Ventricular Tumors

et al. 2005

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Operative TechniqueThe operation was performed via a median full sternotomy. Cardiopulmonary bypass was established with either bicaval or single right atrial cannulation and single arterial cannulation. While using cardioplegic protection, the left atrium or ascending aorta was opened. Under direct vision, the inside of the left ventricle was scarcely visible through the mitral or aortic valve. As a result, an endoscope (XQ240; Olympus, Tokyo, Japan) was inserted into the left ventricular cavity through the mitral or aortic valve. The endoscopic operator stood on the left side of the patient in order to manipulate the endoscope easily (Fig. 1). The endoscope provided an excellent view of the left ventricular cavity and a tumor (Fig. 2a). In our cases, the tumor was attached with a stalk to the left ventricular wall. If the tumor was located on the posterior wall, then visualization of the stalk was relatively difficult. In such cases, after filling the left ventricle with a nonconducting solution, for example, 5% d-sorbitol solution, the tumor thus began to float, allowing us to visualize the tumor. Next, the stalk was snared and cut with high-frequency surgery units (ERB ICC200, Tokyo, Japan) (Fig. 2b). The tumor was retrieved using biopsy forceps and then it was removed with the endoscope (Fig. 2c). A prompt histological examination showed the resected margin to be free of any neoplasm. If the resected area appears to be incomplete, then an additional resection can be performed by either endoscopy or a direct ventriculotomy. There were no complications associated with this technique. DiscussionThe technique described above was performed on two patients. The first was an 82-year-old asymptomatic woman who underwent coronary artery bypass grafting Abstract Two cases involving patients who underwent a successful endoscopic resection of a left ventricular tumor are presented herein. One was an 82-year-old woman with a left ventricular papillary fibroelastoma, who underwent previous coronary artery bypass grafting. In an attempt to make the procedure less invasive, we used an endoscope. With a full sternotomy, cardiopulmonary bypass, and cardioplegic protection, the endoscope was inserted into the left ventricular cavity through the mitral valve. The other patient was a 63-year-old man with left ventricular papillary fibroelastoma, in whom we performed an endoscopic transaortic resection. The endoscope provided an excellent view, and the tumors were easily extracted in both cases without any complications.

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Intraoperative trans-mitral endoscopic resection of left ventricular tumor

Cited by 5 publications

References 5 publications

A systematic review of left ventricular cardio-endoscopic surgery

A systematic review of left ventricular cardio-endoscopic surgery

Intraoperative bronchoscopic resection of a papillary fibroelastoma in the left ventricular outflow tract after aortic mechanical valve replacement

Intraoperative Endoscopic Resection of Left Ventricular Tumors

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