Resection of Left Atrial Myxoma via a Superior Septal Approach

Very fine video in surgical technique and quality of production, Typical of Dr Blitz's numerous instruction films. Thanks

Thank you for your kind comment, Dr. Reed.

Can anybody give me some data on Pacemaker requirements. I operated a young women using this approach for a small Myxoma. She the went on to develop sinus node problems which persisted even 6 months after surgery, so i finaly inserted an AAI pacemaker. Now she is fine. One Atrial lead isnt a big deal, but i wonder whether a left atrial approach alone might not have been sufficient. Any thoughts?

The superior septal approach has about a twofold higher permanent pacemaker requirement than a conventional LA approach , (Lukac 2007). Certainly, one could accomplish the mass excision via a left atrial approach, but the exposure would not be as good. In my opinion, the risk of greater sinus node dysfunction resulting in permanent pacemaker placement is worth the better exposure obtained via the superior septal approach, but I am sure there are others who would disagree.