Minimally Invasive Inframammary Approach to Left Atrial Myxoma Resection
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SURGERY
Minimally Invasive Inframammary Approach to Left Atrial Myxoma Resection Jimmy J. H. Kang 1 & Sabin J. Bozso 2 & Angela Neufeld 3 & Peter Kwan 4 & Michael C. Moon 2 & Jeevan Nagendran 2,5 Accepted: 27 August 2020 # Springer Nature Switzerland AG 2020
Abstract Minimally invasive techniques for myxoma resection are rapidly becoming standard of care for such lesions. Inframammary incisions are commonly used in breast reconstruction. The use of this previous incision for myxoma resection is safe and serves as a cosmetically superior site for female patients. We describe a patient who underwent successful atrial myxoma resection through a previous breast augmentation inframammary incision. Keywords Minimally invasive . Myxoma . Percutaneous peripheral cardiopulmonary bypass . Mini-thoracotomy . Cardiac tumour
Introduction Cardiac myxomas with a left interatrial septal origin represent the most common type of cardiac tumours that frequently present between the third and sixth decades of life [1]. Traditionally, left atrial myxomas are promptly resected though a full sternotomy to reduce their risk of embolism. For younger female patients who have undergone breast augmentation surgery through an inframammary surgical approach, utilization of the prior incision site to resect the myxoma offers a superior aesthetic result. Herein, we describe a This article is part of the Topical Collection on Surgery Electronic supplementary material The online version of this article (https://doi.org/10.1007/s42399-020-00492-w) contains supplementary material, which is available to authorized users. * Jeevan Nagendran [email protected] 1
Medical School, University of Alberta, Edmonton, Alberta, Canada
2
Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
3
Division of Cardiac Anesthesia, University of Alberta, Edmonton, Canada
4
Division of Plastic Surgery, Department of Surgery, University of Alberta, Edmonton, Canada
5
Minimally Invasive and Transcatheter Valve Surgery, Mazankowski Alberta Heart Institute, University of Alberta, 4-108A Li Ka Shing Health Research Centre, 8602 - 112 Street, Edmonton, AB T6G 2E1, USA
patient who underwent a successful minimally invasive surgical (MIS) resection of left atrial myxoma using a right inframammary approach.
Case A 46-year-old woman with a previous history of left-sided ductal invasive carcinoma presented with an incidental finding of a left atrial mass on transthoracic echocardiogram. The patient had previously undergone a total mastectomy of her left breast in 2007 followed by adjuvant chemotherapy, radiation therapy, left breast reconstruction, and right breast augmentation with a silicone implant. She had three additional excisions of left chest wall recurrences following the mastectomy and a replacement of the silicone implant of the right breast to saline implant 11 years after the initial implant. Due to the history of cancer recurrences, steady-state free precession (SSFP) cine MRI and T1 and T2 imagining were order
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