Totally endoscopic 3D resection of a left ventricular myxoma arising from the papillary muscle: a case report.

BACKGROUND: Left ventricular myxoma is rare and carries a risk of systemic embolization, particularly when it is mobile. Surgical exposure is challenging for tumors arising from the papillary muscle. CASE PRESENTATION: A 52-year-old woman presented with intermittent chest pain. Echocardiography revealed a mobile 10 × 18 mm left ventricular mass attached to the anterior papillary muscle. Because of the embolic risk, she underwent totally endoscopic, 3D, transmitral resection. Exposure was achieved by direct left atriotomy, atrial suspension sutures, and endoscopic elevation of the anterior mitral leaflet. The tumor was sharply excised and retrieved in an endobag, and the chambers were irrigated. Cross-clamp and cardiopulmonary bypass times were 35 and 56 minutes, respectively. Recovery was uneventful, and she was discharged on postoperative day 6. Histopathology confirmed a myxoma. At 12 months, no recurrence or mitral dysfunction was observed at 12 months. CONCLUSION: Totally endoscopic 3D transmitral resection may be feasible for selected cases of left ventricular myxoma while preserving the mitral apparatus.