Robotic Left Atrial Myxoma Resection

In this video, the author demonstrates a robotic left atrial myxoma resection. The author uses the same approach for all valve operations including AVRs and MV repairs, and an identical approach for HOCM. This video demonstrates the same technique being applicable to myxoma resection.

Four 8 mm Intuitive robotic ports were used for the endoscope and three instruments, and a fifth port was a utility incision for the assistant and for removal of the myxoma in this case.

Each operation commences with insertion of the cardioplegia cannula, and then use of the Chitwood clamp and arrest of the heart. Then, for this case, the left atrium was opened in Sondegaard's groove, which provided an excellent view of the left atrium, mitral valve, and the very large myxoma in this patient. Great care was taken to remove the stalk of the myxoma off the anterior leaflet of the mitral valve and in resection of the stalk of the myocardium of the left atrium.

After successful removal, the left atrium was closed with a two-layered suture technique, the cross clamp was removed, and the heart was restarted. No atrioventricular wires were required and the right lung was simply inflated postoperatively. The patient was extubated on the table and mobilized the same day.