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SIMS Hospitals successfully performed India’s first Endoscopic Left Ventricular tumour removal, a key hole minimally invasive surgeryavoiding the need for breast bone cutting (sternotomy). This was done for a very rare tumour that has grown inside the heart’s main pumping chamber, in a 45-year-old female patient. The patient, a working woman, incidentally diagnosed to have a mass attached to the main pumping chamber of the heart (the left ventricle). An MRI of the heart confirmed it to be a left ventricular mass/thrombus measuring 1.6 × 1.5 cm. Primary cardiac tumours accounts for only about 0.6% of all cardiac surgeries performed in the country. Specifically, the left ventricular tumour is extremely rare, occurring in only about one in 20-30 million people.The usual approach for treating this condition is a sternotomy, an open-heart surgery.However, doctors at SIMS Hospitals opted for an endoscopic cardiac surgery, a minimally-invasive keyhole procedure. It involves creating small openings between the ribs, passing through the muscle, accessing the chambers of the heart, and removing the tumour. The elective procedure successfully removed the tumour and eliminated the risk of complications like stroke. The surgery was performed by Dr. A. Mohammed Ibrahim, Consultant - Cardiothoracic Surgeryunder the guidance of Dr. V. V. Bashi, Director & Senior Consultant - Institute of Cardiac & Advanced Aortic Diseases.The surgery involvedendoscopic guidance and specialised minimally invasive instruments to remove the tumour. Congratulating the team on this historicachievement, Dr. Ravi Pachamuthu, Chairman, SIMS Hospitalsaid,“This success reflects the strength of our clinical environment, the sophistication of our endoscopic capabilities and infrastructure, and above all the dedication and precision of our team. Together, we continue to uphold the highest standards of care and deliver hope and healing when it matters most.” In his comments, Dr V. V. Bashi said, “Left ventricular mass is a rare condition, and performing its removal through a minimally invasive technique is exceptionally uncommon in the world. It is done for the first time in India. The patient was under general anesthesia and placed on heart-lung machine support through the blood vessels in the right groin. Through a tiny 3 cm incision, right chest cavity was approached. Right lung was collapsed, after the patient was initiated on heart-lung machine support. Heart was stopped and chambers of the heart were opened.Endoscope was used to visualise the main pumping chamber and the tumour was excised completely. The chambers were closed and the heart was allowed to beat. The patient was gradually weaned off the heart-lung machine. She is now completely normal and has resumed her routine work without any discomfort in two weeks.” Commenting on the benefits of the key-hole surgery, Dr Mohammed Ibrahim said, “cardiac surgery generally involves cutting through the central sternal bone, which increases pain, hospital stay and the risk of morbidities. However, endoscopic cardiac surgery is an advanced minimally invasive approach that enables faster recovery while reducing pain and blood loss. It also avoids a prominently visible scar in the middle of the chest after surgery. Endoscopic assistance further enhances precision and allows us to access areas that may not otherwise be easily reachable. We have already performed five such cases with a 100% success rate. We also use minimally invasive approaches to treat other cardiac conditions such as coronary artery disease, valvular heart disease, septal defects of the heart, and mediastinal tumours. About 90% of cardiac tumours happen due to random changes in the heart’s cells, with no clear reason. The remaining 5-10% occur in people who have a genetic tendency to develop these tumours.