title: Anesthetic management of the removal of a giant metastatic cardiac liposarcoma occupying right ventricle and pulmonary artery.
abstract: A 60 years old chinese male scheduled for a removal of an intracardiac mass occupying majority of right ventricular space, right ventricular outflow tract and pulmonary artery. The giant cardiac mass was later diagnosed pathologically as metastatic liposarcoma. The patient had a history of surgical removal of myxoid liposarcoma from his left thigh many years ago. It is extremely rare for liposarcoma to metastatize to right ventricle and pulmonary artery. The anesthetic management of the surgical procedure to remove this kind of intracardiac mass poses significant challenges to anesthesia providers. Our patient developed refractory hypotension after induction of general anesthesia which necessitated urgent cardiopulmonary bypass. The surgical procedure was successful and the patient recovered from the surgery and was discharged home without significant complication. Accurate preoperative diagnosis and assessment of patient's functional status, appropriate preoperative volume status, emergency cardiopulmonary bypass readiness, smooth and gentle induction of general anesthesia with less myocardial depressing agent, and closely monitoring patient's vitals and hemodynamic parameters are imperative in managing this kind of patients.
authors.forename: Jianhong
authors.initials: J
authors.lastname: Xu
authors.forename: Yueying
authors.initials: Y
authors.lastname: Zheng
authors.forename: Liqing
authors.initials: L
authors.lastname: Wang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Feng
authors.forename: Ceyan
authors.initials: C
authors.lastname: Yu
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China. smzhu20088@163.com.
authors.forename: Shengmei
authors.initials: S
authors.lastname: Zhu
mesh_terms: D000758:Anesthesia / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000379:methods; D017548:Echocardiography, Transesophageal; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008080:Liposarcoma / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography