Right atrial myxoma associated with acute cor pulmonale. Case report.
OBJECTIVE
Atrial myxomas are the most common type of primary intracardiac tumors. Although they are benign, it is recommended its immediate removal as soon as the diagnosis is confirmed, since they are associated with tumor embolization and their harmful consequences. The objective of this report was to present the case of an intracardiac tumor of rare location (right atrium) that developed intraoperative embolization and to alert anesthesiologists for the possibility of this complication, besides discussing the anesthetic conduct.


METHODS
A male patient, 42 years old, presented with a large mass in the right atrium, being scheduled for removal of the tumor. Anesthetic induction consisted of ethomidate, fentanyl and rocuronium bromide and it was maintained with isoflurane and fentanyl. Intraoperatively, the patient developed acute cor pulmonale secondary to tumor embolization, with the immediate institution of support measures and cardiopulmonary bypass. The remaining of the surgery was uneventful and the patient was discharged on the 7th postoperative day in good conditions.


CONCLUSIONS
Although intracardiac myxoma is a benign tumor, it can be associated with severe and even fatal complications. Knowledge of the disease is important for the proper management of those patients by the anesthesiologist, as well as to diagnose and treat possible intraoperative complications.
Lorentz
Michelle Nacur
MN
Biocor Instituto, Hospital de Doenças Cardiovasculares, Nova Lima, MG. mnacur@yahoo.com.br
Vrandecic
Ektor Corrêa
EC
Drumond
Leonardo Ferber
LF
Soares
Raquel Reis
RR
D000208:Acute Disease; D000328:Adult; D006325:Heart Atria; D006338:Heart Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D009232:Myxoma / Q000150:complications*; D011660:Pulmonary Heart Disease / Q000150:complications*