Thoracoscopic Removal of a Papillary Fibroelastoma in the Left Ventricular Apex

Primary cardiac tumors located deep in the left ventricle present a surgical challenge. A mobile tumor located in the left ventricular apex was incidentally discovered on echocardiography in an 81-year-old female. The tumor was removed using a combined sternotomy and chest-port approach assisted by thoracoscopy. The use of an endoscopic sucker, instead of an endoscopic grasper, to retract the tumor helped keep the removal of the tumor en bloc uncomplicated. Detailed preoperative information about tumor location, size, and attachment to the endocardium facilitated the planning of the surgical approach and the instrumentation needed, which led to the successful removal of the deeply located left ventricular tumor. The surgical approach and instrumentation of previous case reports are reviewed.