Objective:To explore the feasibility of atrial myxoma resection under total thoracoscopy using a right-side approach through a cardiopulmonary bypass（CPB）

and to evaluate its clinical safety and application value.Methods:A retrospective analysis was performed on 32 patients（14 males

18 females） who had undergone cardiac myxoma（left atrial myxoma in 30 cases and right atrial myxoma in 2 cases） resection under total thoracoscopy from December 2011 to December 2018 in Chongqing People ’ s Hospital（Chongqing General Hospital

University of Chinese Academy of Sciences）.The preoperative New York Heart Association classification of cardiac function showed the following:grade Ⅰ in 8 cases

grade Ⅱ in 17 cases

and grade Ⅲ in 7 cases.A CPB was established by intubation of the femoral artery and vein and intubation of the right internal jugular vein for drainage;the ascending aorta was blocked under total thoracoscopy using a right-side approach;the myxoma was resected through the right atrial and interatrial septal approach after cardiac arrest.Results:No perioperative death occurred.The time of operation

CPB time

and time of aortic occlusion were（176.13±8.12）min

（132.19±6.45）min

and（70.94±3.80）min

respectively.The volume of blood loss up to 48 h after operation was（283.71±44.28）mL;10 patients received intraoperative blood transfusion

resulting in a transfusion rate of 31.25%;the median transfusion volume was 2 units（range:0-4）.Intraoperative transesophageal ultrasonography and pre-discharge echocardiography reexamination suggested that the cardiac myxoma was completely removed without any residue.All of the cardiac valves functioned well.During the follow-up period

there was no recurrent cardiac myxoma

second operations due to valvular diseases

or any serious cardiovascular and cerebrovascular complications.Conclusion:Atrial myxoma resection under total thoracoscopy using a right-side approach through a CPB is safe and feasible

with definite clinical effect and minimal surgical trauma and postoperative scars

which is beneficial to the recovery of patients after operation.