Key result
Pre-induction cardiopulmonary bypass enables safe resection of an obstructive right atrial myxoma.
Why the study?
In patients with an obstructive right atrial mass, inducing general anesthesia raises concern for cardiovascular collapse due to hypotension and bradycardia.
Does establishing cardiopulmonary bypass before general anesthesia prevent cardiovascular collapse in a patient with an obstructive right atrial myxoma?
Case Report (n=1)
Does establishing cardiopulmonary bypass before general anesthesia prevent cardiovascular collapse in a patient with an obstructive right atrial myxoma?
Establishing cardiopulmonary bypass before general anesthesia may be a safe and effective strategy to prevent cardiovascular collapse in patients with large cardiac masses obstructing central venous return.
Pre-anesthesia CPB may be feasible in obstructive RA myxoma; leaves open need for prospective validation.
We describe a case of establishing cardiopulmonary bypass (CPB) before general anesthesia in a person who has an obstructive right atrial myxoma protruding into the right ventricle (RV). A 27-year-old female endorsed shortness of breath on exertion, dry cough, and palpitations, with a cardiac MRI exhibiting a severely enlarged right atrium (RA) with a 65 mm x 40 mm mass. The mass obstructed the tricuspid valve from closing and extended into the RV, leading to an ejection fraction (EF) of 49%. The obstruction caused concern for cardiovascular collapse due to hypotension and bradycardia that may be provoked by inducing general anesthesia. Under local sedation, the femoral vessels were cannulated, CPB was initiated, and the patient received general anesthesia. A median sternotomy was completed, and traditional CPB was established. After the heart was arrested, the RA was opened, and the mass was resected along with a full-thickness section of the RA. This case report supports preoperative CPB for patients undergoing general anesthesia to correct a cardiac mass that is obstructing central venous return.
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Beisenova et al. (2026) conducted a case report in Obstructive right atrial myxoma (n=1). Establishing cardiopulmonary bypass (CPB) before general anesthesia was evaluated on Successful resection of the mass. Establishing cardiopulmonary bypass before general anesthesia allowed for the safe and successful resection of an obstructive right atrial myxoma.
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