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J Thorac Cardiovasc Surg 2008;136:537-538
© 2008 The American Association for Thoracic Surgery

Letter to the Editor

Removal of left ventricular tumors by a transaortic transvalvular approach with the help of thoracoscopic instruments

Alexandre Le Guyader, MD, Marc Laskar, MD

Thoracic and Cardiovascular Surgery Department, University of Limoges and Limoges University Hospital, Limoges, France

To the Editor:

We read with interest the case report from Walkes and colleagues1Go describing their new technique to resect a left ventricular fibroelastoma. Indeed, a left ventricular tumor location can be a real challenge for surgeons when a transmitral approach is performed. We agree with the authors that a safe and more reasonable surgical approach can be used through the aortic valve with the help of a thoracoscope and thoracoscopic instruments.

However, we want to highlight that this technique has already been published. We2Go described in 2006 this same surgical approach (Go Figures 1), which helped us to ensure the mass nature, its resectability, and its single location, since in a few cases multiple tumors can be found operatively but undetected by preoperative echocardiography. In 1997, Espada and colleagues3Go also published the use of a thoracoscope through a left atrial approach to visualize and resect a left ventricular fibroelastoma.


Figure 1
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  		Figure 1. Excision of a mitral valve papilary fibroelastoma through an aortotomy with the help of a thoracoscope and thoracoscopic instruments.

 
We are thankful for this other report, which highlights a safe but unusual procedure to remove left ventricular tumors.

References

  1. Walkes JC, Bavare C, Blackmon S, Reardon MJ. Transaortic resection of an apical left ventricular fibroelastoma facilitated by a thoracoscope. J Thorac Cardiovasc Surg 2007;134:793-794.[Free Full Text]
  2. Le Guyader A, Nubret K, Darodes N, Laskar M. Removal of a ventricular mitral valve fibroelastoma by an aortic approach. Interact Cardiovasc Thorac Surg 2006;5:785-787.[Abstract/Free Full Text]
  3. Espada R, Talwalker NG, Wilcox G, Kleiman NS, Verani MS. Visualization of ventricular fibroelastoma with a video-assisted thoracoscope. Ann Thorac Surg 1997;63:221-223.[Abstract/Free Full Text]




This Article
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Marc Laskar
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