Femoro-femoral cardiopulmonary bypass for the resection of an anterior mediastinal mass

Abstract

The perioperative management of patients with mediastinal mass is challenging. Complete airway obstruction and cardiovascular collapse may occur during the induction of general anaesthesia, tracheal intubation, and positive pressure ventilation. The intubation of trachea may be difficult or even impossible due to the compressed, tortuous trachea. Positive pressure ventilation may increase pre-existing superior vena cava (SVC) obstruction, reducing venous return from the SVC causing cardiovascular collapse and acute cerebral oedema. We are describing here the successful management of a patient with a large anterior mediastinal mass by anaesthetizing the patient through a femoro-femoral cardiopulmonary bypass (fem-fem CPB).

Predicting intraoperative cardiovascular complication in patients with anterior mediastinal mass-role of central venous pressure monitoring

“…When the patient has definite signs, the peri-operative management strategy and the procedural risks are self explanatory. [5] But in an asymptomatic patient like ours, with potential cardiovascular complication posted for major therapeutic procedure, the preoperative risk stratification and the management plan is crucial for safer outcome. Hence, we did literature search to identify the preoperative factors that predict the risk of developing haemodynamic compromise on induction in an asymptomatic patient.…”

Emergency management of a patient with severe airway obstruction resulting from poorly differentiated thyroid carcinoma: A case report

“…In the field of malignant airway obstruction, cardiopulmonary bypass has been used for the management of airway in a few case reports. Sendasgupta et al (4) reported the successful management of a patient with a large anterior mediastinal mass which compressed and distorted the trachea through a femoro-femoral cardiopulmonary procedure. In a patient with an aggressive thyroid papillary carcinoma invading the trachea, curative surgery and reconstruction were performed by cardiopulmonary bypass oxygenation (5).…”

Anesthetic Management in a Patient With Type A Aortic Dissection and Superior Vena Cava Syndrome

“…Sendasgupta et al described a successful experience in the management of a patient with SVC syndrome due to a large anterior mediastinal mass by anaesthetizing the patient through a femorofemoral cardiopulmonary bypass (16).…”