# Transaortic removal of a large primary sarcoma from the left ventricle assisted by strategic partial resection and endoscopic guidance: a case report

## TL;DR

A new surgical technique using partial resection and endoscopic guidance successfully removed a large heart sarcoma.

## Contribution

A novel transaortic approach with strategic partial resection and endoscopic guidance for large left ventricular sarcomas is presented.

## Key findings

- A 74-year-old woman's large left ventricular sarcoma was successfully removed using a transaortic approach.
- Interim partial resection and endoscopic guidance enabled complete tumor removal with tumor-free margins.

## Abstract

Surgical resection remains the mainstay of treatment for cardiac sarcoma, a rare but lethal disease. Achieving complete removal of a large-sized left ventricular sarcoma remains a challenge even with various surgical approaches that have been employed.

We present a case of a 74-year-old woman with shortness of breath who underwent surgical removal of a primary cardiac sarcoma, measuring 6 × 3.5 × 3 cm, attached to the septum of the left ventricle and caused sub-aortic valve obstruction. Transaortic approach was chosen and the access to this entire huge mass was enabled by using interim partial resection which created a space for further dissection and subsequent deeper endoscopic views. The further dissection was finally able to be advanced on the apex, and the residual mass was completely resected with gross tumor-free margins.

Interim partial resection and endoscopic guidance can highly facilitate the transaortic removal of even large left ventricular sarcomas.

The online version contains supplementary material available at 10.1186/s13019-024-02489-1.