title: Anesthetic Management of a Patient With a Giant Right Atrial Myxoma.
abstract: Cardiac myxomas account for 50% of all benign primary cardiac tumors. Rarely, these tumors occur in the right atrium (RA; 10% to 20%), with a stalk frequently attached to the interatrial septum. Right atrial myxomas can lead to RA enlargement, arrhythmias, functional tricuspid stenosis, right heart failure, and catastophic pulmonary embolization resulting in sudden cardiac death. Anesthetic management of patients with RA myxomas can be complicated by the mass effect of the myxoma, preload limitations, and the potential for cardiovascular collapse. Multimodal cardiac imaging inclusive of echocardiography, computed tomography, and magnetic resonance imaging helps with the diagnosis, preoperative optimization, and formulation of anesthetic and surgical plans. We present a case report highlighting the importance of multimodal imaging, adequate preoperative patient optimization, and the anesthetic considerations in the successful management of a patient with a giant 8.3 × 4.7 cm RA myxoma.
authors.affiliation: The Ohio State University, Columbus, OH, USA michael.essandoh@osumc.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Essandoh
authors.affiliation: The Ohio State University, Columbus, OH, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Andritsos
authors.affiliation: The Ohio State University, Columbus, OH, USA.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kilic
authors.affiliation: The Ohio State University, Columbus, OH, USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Crestanello
mesh_terms: D000758:Anesthesia / Q000379:methods*; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014264:Tricuspid Valve Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery
keywords: functional tricuspid stenosis; general anesthesia; myxoma; right atrium; transesophageal echocardiography