Transaortic resection of an apical left ventricular fibroelastoma facilitated by a thoracoscope

Walkes, Jon Cecil; Bavare, Charudatta S.; Blackmon, Shanda H.; Reardon, Michael J.

doi:10.1016/j.jtcvs.2007.05.019

Cited by 15 publications

(11 citation statements)

References 4 publications

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“…The most common type of endoscopic device used was rigid endoscope [1, 5, 8, 12–14, 19, 22, 23, 32, 33, 36, 37], reported in 13 studies. 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].…”

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%

“…In 12 studies, the follow-up was longer than 30-days and no mortalities were observed [2, 3, 5, 6, 8, 9, 12, 25, 26, 31, 33, 35]. The only postoperative complication observed was one case of atrial fibrillation (2.2%, 1/46).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of left ventricular cardio-endoscopic surgery

Soylu

Kidher

Ashrafian

et al. 2017

J Cardiothorac Surg

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“…There are three ways to approach cardiac tumors in the left ventricular cavity: (i) the transmitral valvular approach; (ii) the transaortic valvular approach; and (iii) the transmural approach . The transmural approach requires an incision into the left ventricular muscle, which can lead to left ventricular dysfunction; the transaortic valvular approach is likely to have the least adverse effect.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, cases of an endoscopic transvalvular resection of papillary fibroelastoma deep in the left ventricle have been reported. Some groups have performed direct resection of the tumor under endoscopic visualization using a rigid‐type thoracoscope or mediastinoscope . Others have visualized and removed the tumor with a snare with a flexible endoscope or gastrointestinal fiberscope and avoided the use of a rigid type with a straight shaft because of its inflexibility and poor handling .…”

Section: Discussionmentioning

confidence: 99%

Video‐assisted endoscopic resection of left ventricular papillary fibroelastoma through the aortic valve

Ishida

Satokawa

Takase

et al. 2016

Asian J Endoscop Surgery

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Papillary fibroelastoma is a rare, benign cardiac tumor. Surgical resection is indicated to prevent embolization. We herein report a case of a 78-year-old asymptomatic man who was found to have a mobile left ventricular papillary fibroelastoma anchoring deep in the left ventricle by incidental transthoracic echocardiography. The tumor was resected under visualization by a video-assisted rigid endoscope with a flexible head inserted through the aortic valve into the left ventricle. Intraoperative frozen section analysis provided a pathological diagnosis of papillary fibroelastoma. The postoperative course was uneventful. This technique is recommended for the observation and resection of a tumor anchoring deep in the left ventricle and is helpful for avoiding the adverse effects of left ventriculotomy.

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“…Algunos autores comunican el uso de toracotomías o mini esternotomías como medio de abordaje de estos tumores en estos pacientes con diferentes resultados [30][31][32] .…”

Section: Discussionunclassified

Fibroelastoma valvular aórtico como causa de accidente cerebrovascular embólico: Reporte de un caso

et al. 2008

Rev Chil Cir

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RESUMENLos tumores cardíacos son una causa rara de accidente cerebrovascular embólico. Comunicamos el caso de una paciente de 65 años quien debuta su historia con un accidente cerebrovascular. El estudio de fuente embólica con ecocardiografía transesofágica demostró un fibroelastoma de la válvula aórtica en el borde libre del velo no coronariano. El tumor fue extraído mediante circulación extracorpórea. El estudio anatomopatológico confirmó el diagnóstico y la paciente se encuentra en capacidad funcional I y sin síntomas neurológicos a 19 meses de seguimiento.PALABRAS CLAVE: Procedimientos quirúrgicos cardíacos, válvulas cardíacas, válvula aórtica, tumores cardíacos. ABSTRACTBackground: Cardiac tumors are an infrequent cause of an embolic source and aortic fibroelastoma is even more rare as causative of a stroke. We report a 65 year old female with no particular clinical history admitted to the hospital with an embolic cerebrovascular accident whose embolic source study with a transesophageal echocardiogram revealed a fibroelastoma in the free edge of the non coronarian leaflet of the aortic valve. The patient was subjected to surgery by means of extracorporeal circulation and the tumor was excised. The pathological study confirmed the diagnosis. Post operative recovery was uneventful with no neurological damage and after 19 months of follow up she is in functional class I.

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Transaortic resection of an apical left ventricular fibroelastoma facilitated by a thoracoscope

Cited by 15 publications

References 4 publications

A systematic review of left ventricular cardio-endoscopic surgery

A systematic review of left ventricular cardio-endoscopic surgery

Video‐assisted endoscopic resection of left ventricular papillary fibroelastoma through the aortic valve

Fibroelastoma valvular aórtico como causa de accidente cerebrovascular embólico: Reporte de un caso

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