Why the study?
The pathogenesis of cerebral vascular disease related to atrial myxoma is not well known, and guidelines to guide treatment and anesthesia management in patients with multiple cerebral aneurysms are lacking.
Fast track cardiac anesthesia with TEE and PbtO2 monitoring is safe and effective for early neurological evaluation in patients undergoing atrial myxoma resection with coexisting cerebral aneurysms.
Requires cautious individualized management in this rare association; leaves open pathogenesis and treatment guidelines.
BACKGROUND: Embolic stroke is a common complication of atrial myxoma, whereas multiple cerebral aneurysms associated with atrial myxoma is rare. The pathogenesis of the cerebral vascular disease related to an atrial myxoma is still not well known, and there are no guidelines to guide treatment and anesthesia management in such patients. CASE PRESENTATION: In this report, we present a 38-year-old woman with occasional dizziness and headache diagnosed as multiple cerebral fusiform aneurysms, in whom transthoracic echocardiography revealed a mass attached to the interatrial septum in the left atrium. Myxoma resection was performed in fast track cardiac surgery pathway without neurological complications, and no intervention was carried out on the cerebral aneurysms. She was discharged home 6 days after the procedure for followed-up. Furthermore, we reviewed and analyzed the literature in the PubMed and Google Scholar databases in order to conclude the optimal treatment in such cases. CONCLUSIONS: monitoring play an essential role in anesthesia management. Fast track cardiac anesthesia is safe and effective to early evaluate neurological function. Long term follow-up for "myxomatous aneurysms" is recommended. And outcome of most patients is excellent.
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Zhang et al. (2020) studied this question.
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