Anesthetic Management of a Patient With a Giant Right Atrial Myxoma. (March 2016)

• Record Type: Journal Article
• Authors: Essandoh, Michael; Andritsos, Michael; Kilic, Ahmet; Crestanello, Juan
• Is Part Of: Seminars in cardiothoracic and vascular anesthesia. Volume 20:Number 1(2016:Mar.)
• Page Start: 104
• Page End: 109
• Publication Date: 2016-03
• Subjects: right atrium -- general anesthesia -- functional tricuspid stenosis -- transesophageal echocardiography -- myxoma; Cardiovascular system -- Surgery -- Methods -- Periodicals; Chest -- Surgery -- Methods -- Periodicals; Anesthesia -- Periodicals; Anesthetics -- Periodicals; Anesthesia -- Periodicals; Anesthetics -- Periodicals; Cardiovascular Surgical Procedures -- methods -- Periodicals; Thoracic Surgical Procedures -- methods -- Periodicals; 617.96
• DOI: 10.1177/1089253215584194
• Languages: English
• ISSNs: 1089-2532

Abstract

Cardiac myxomas account for 50% of all benign primary cardiac tumors. Rarely, these tumors occur in the right atrium (RA; 10% to 20%), with a stalk frequently attached to the interatrial septum. Right atrial myxomas can lead to RA enlargement, arrhythmias, functional tricuspid stenosis, right heart failure, and catastophic pulmonary embolization resulting in sudden cardiac death. Anesthetic management of patients with RA myxomas can be complicated by the mass effect of the myxoma, preload limitations, and the potential for cardiovascular collapse. Multimodal cardiac imaging inclusive of echocardiography, computed tomography, and magnetic resonance imaging helps with the diagnosis, preoperative optimization, and formulation of anesthetic and surgical plans. We present a case report highlighting the importance of multimodal imaging, adequate preoperative patient optimization, and the anesthetic considerations in the successful management of a patient with a giant 8.3 × 4.7 cm RA myxoma.