Careful preoperative optimization and vigilant monitoring can enable safe anesthetic management for the surgical removal of extremely large right atrial myxomas with caval extension.
May support safe anesthesia with optimization in select large right atrial myxomas; leaves open generalizability and need for further evidence.
Atrial myxomas are the most common primary intracardiac tumors. Only rarely do they arise from the right atrium with a variable clinical presentation. We report on the anesthetic management of an extremely large myxoma arising in the right atrium which had significant extension into both the inferior vena cava (IVC) and superior vena cava (SVC). This case poses unique challenges to both surgeons and anesthesiologists because of the potential for cardiovascular collapse with induction, bleeding, emboli, and significant postoperative complications. With careful preoperative optimization including fluid resuscitation and vigilant monitoring, this patient was able to have a safe anesthetic for her surgical removal of this complex mass.
No takes yet. Share an insight, caveat, or question.
A 2016 study studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: