Surgical approach to a left ventricular myxoma guided by transesophageal and epicardial dual-view echocardiography: a case report

BACKGROUND: Left ventricular myxoma is a rare benign cardiac neoplasm. Surgical excision is the treatment of choice, and complete removal is mandatory to prevent late recurrence. CASE PRESENTATION: Here, we report a case of myxoma originating from the anterolateral wall of the left ventricle with a very short stalk. Accordingly, the transaortic and transmitral approaches were considered inadequate; therefore, a transventricular approach was adopted. To minimize the incidence of complications associated with a left ventriculotomy, its length was designed to be as short as possible. To plan a proper ventriculotomy, measurements were taken by the combined use of transesophageal echocardiography and epicardial direct echocardiography. CONCLUSIONS: This method provided a good guide without being a complicated technique. The tumor and its attachment were clearly visualized and completely resected in an en bloc fashion. No recurrence has occurred to date.