Year: 2022
Type: article
Study design: Case Report
Abstract: Clinical vignetteA 67-year-old male presented with a 2-month history of lightheadedness and a near-syncopal episode.Transesophageal echocardiogram (TEE) demonstrated a mobile, 4.1 cm mass in the superior and medial aspect of the left atrium concerning for myxoma.Coronary angiography demonstrated tumor neovascularization with a primary feeder vessel arising from the proximal right coronary artery. Surgical techniques Preparation and induction of anesthesiaAfter induction of general anesthesia, a single lumen tube with a bronchial blocker is placed.The patient's arms are tucked and the right chest is elevated up to 30 degrees.A venous cannula is inserted via the right neck into the superior vena cava percutaneously under ultrasound guidance.A TEE probe is inserted.The patient is then prepped and draped, widely exposing the entire chest and both groins. Thoracotomy and port placementSingle lung ventilation with complete right lung collapse is initiated.A right mini thoracotomy is performed in the fourth intercostal space anterior to the anterior axillary line.A small Alexis soft tissue retractor is inserted, over which a small metal retractor may be placed as needed.If necessary for exposure, a pledgeted diaphragmatic traction suture is placed and brought out through the inferolateral chest wall.
Source: Annals of Cardiothoracic Surgery
Language: English
Topic: Cardiac tumors and thrombi
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4289860437