Totally thoracoscopic surgery for atrial myxomas resection and atrial septal defect repair.

OBJECTIVE The purpose of this study is to compare the effectiveness and safety of thoracoscopic surgery and traditional median sternotomy. PATIENTS AND METHODS 64 patients with atrial myxoma and 114 patients with atrial septal defect were collected from Mar 2012 to Aug 2015. 40 atrial myxoma and 77 atrial septal defect (ASD) patients underwent totally thoracoscopic surgery technique, while 24 atrial myxoma and 37 ASD patients underwent traditional median sternotomy. The baseline characteristics and perioperative data were recorded and analyzed from all cases. Follow-up data were obtained from outpatient clinics. RESULTS All patients had successful resections or repairs. Compared with the traditional median sternotomy, the patients with atrial myxoma who underwent thoracoscopic surgery had longer operation time (208.08 ± 23.98 vs. 170.00 ± 16.58 min) while shorter intensive care unit (ICU) stay time (17.67 ± 4.95 vs. 49.88 ± 3.21 h), less blood drainage (127.87 ± 48.84 vs. 275.00 ± 59.01 ml) and shorter hospitalization days (9.97 ± 3.54 vs. 15.13 ± 1.06 days). For patients underwent ASD repair, longer operation time (232.92 ± 61.02 vs. 183.40 ± 54.63 min), shorter mechanical assistant ventilation time (4.82 ± 2.10 vs. 6.02 ± 2.50 h) and shorter ICU stay time (18.54 ± 5.80 vs. 39.68 ± 18.44 h) were detected in the thoracoscopic surgery group. There was no postoperative embolism events or death in all participated patients. Neither residual shunt nor atrioventricular blocks were detected in all ASD patients. CONCLUSIONS Totally thoracoscopic surgery for atrial myxomas and atrial septal defect repair is more effective and safer. It provides another option to treat the patients with atrial myxoma and atrial septal defect.