Introduction
Primary cardiac tumors are rare entities1. Approximately 75% are benign with nearly 50% being myxoma2, 3. Surgery should be performed soon after diagnosis. The long-term prognosis of benign tumors is excellent1, but complete removal of the mass is mandatory. Cardiac tumors should be excised with a margin of normal tissue in order to reduce the potential for recurrence. While recurrence rates of benign cardiac tumors are low, relapse is likely the consequence of inadequate excision of the tumor4. Additionally, cardiac chambers should be irrigated and suctioned to prevent embolization of fragments. If a defect is created, it should be closed primarily or with a patch. Median sternotomy (MS) is the common approach for cardiac tumor since it provides excellent exposure. This traditional approach is associated with excellent early and late clinical outcomes and remains the gold standard treatment for primary cardiac tumors1.
Minimally invasive (MI) surgery has emerged as an alternative method to MS. Nevertheless, a main criticism of the MI approach is that, given the limited exposure of the surgical field and the surrounding structures, complete and durable eradication of the cardiac tumor may be compromised compared to the MS approach.
Therefore, the aim of this pairwise meta-analysis was to investigate whether MI may achieve the same early and late outcomes as MS surgery in the context of primary cardiac masses.