Why the study?
Pericardial cysts can occasionally cause life-threatening complications, and data regarding the anesthetic management of patients with giant pericardial cysts undergoing thoracic surgery were lacking.
This case report demonstrates the successful anesthetic management and video-assisted thoracoscopic removal of a giant pericardial cyst compressing the right atrium.
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Supports feasibility of VATS for giant pericardial cysts; leaves open need for larger series before practice change.
Pericardial cysts are rare mediastinal cysts composed of a single fluid-filled mesothelial layer and can be congenital in origin or develop secondary to pericarditis, trauma, or infection. Although most pericardial cysts are asymptomatic, life-threatening complications can occasionally occur. We report on a 57-year-old man with an asymptomatic 9 cm pericardial cyst that was incidentally found as an abnormal cardiac silhouette on routine chest radiography. Further imaging confirmed the presence of a pericardial cyst that was compressing the right atrium. The patient underwent successful video-assisted thoracoscopic removal of the pericardial cyst under general anesthesia. The patient's postoperative course was uneventful and he was discharged on postoperative day 1 in a stable condition. To our knowledge, this is the first report regarding the anesthetic management of a patient with a giant pericardial cyst undergoing thoracic surgery. Knowledge regarding the perioperative challenges associated with the removal of pericardial cysts can prevent complications and improve patient outcomes.
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Gharedaghi et al. (2019) studied this question.
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