Pericardial cyst compressing right atrium and ascending aorta – anesthetic management case report

Abstract

Pericardial cysts are rare, benign congenital mediastinal or cardiodiaphragmatically located cysts which develop secondary to pericarditis, trauma, or infection without communication with pericardial space. Most pericardial cysts are asymptomatic malformations and discovered incidentally which when undetected leads to life-threatening complications like diastolic dysfunction, right ventricular outflow tract obstruction, pulmonary stenosis or congestive heart failure. In this case report we present a 43-year-old female with an asymptomatic 5.5x6.0x6.3 cm pericardial cyst which was incidentally identified as an abnormal cardiac silhouette during routine chest radiography. Chest radiography reports confirmed the presence of a pericardial cyst with compression of the right atrium and ascending aorta. The patient underwent successful thoracoscopic resection of the pericardial cyst under general anesthesia following thoracotomy. The patient’s postoperative course was uneventful and he was discharged on postoperative day 4 in a stable condition. Appropriate mitigation of perioperative challenges associated with the thoracoscopy based resection of pericardial cysts minimizes mortality rate and improve patient outcomes.