Right Atrial Myxoma with Pulmonary Artery Hypertension: Role of Transesophageal Echocardiography in Detection of Cause and Perioperative Management

Munirathinam, Ganesh Kumar; Kumar, Bhupesh; Singh, Harkant

doi:10.1053/j.jvca.2017.07.008

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…Post-CPB TEE would provide an assessment of valve and cardiac function following resection. Like many other studies ( 1 , 7 , 31 , 32 ), we consider intraoperative TEE to be an indispensable instrument in the anesthesia management of cardiac myxoma resection.…”

Section: Discussionmentioning

confidence: 89%

Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysis

Qi¹,

Yu²,

Yang³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundMyxomas are the most common primary cardiac tumors. Intracardiac myxomas, although benign, could cause serious consequences such as tricuspid or mitral valve obstruction, hemodynamic collapse, and acute heart failure, which pose challenges during anesthetic management. The current study was designed to summarize the anesthetic management of patients undergoing cardiac myxoma resection.MethodsThis study was performed retrospectively from the perioperative period of patients who underwent myxoma resection. Patients were divided into two groups according to whether the myxoma prolapsed into the ventricle (group O) or not (group N) to evaluate the impact of tricuspid or mitral valve with obstruction.Results110 patients, aged 17–78 years, undergoing cardiac myxoma resection between January 2019 and December 2021 were collected, and their perioperative characteristics were recorded. In the preoperative evaluation, common clinical symptoms included dyspnea and palpitation, whereas embolic events occurred in 8 patients, including 5 (4.5%) cerebral thromboembolic events, 2 (1.8%) femoral artery, and 1 (0.9%) obstructive coronary artery. According to the echocardiography, left atrial myxoma was detected in 104 (94.5%) patients, the average dimension of myxoma was 4.03 cm ± 1.52 cm in the largest diameter, and 48 patients were divided into group O. During intraoperative anesthetic management, hemodynamic instability occurred in 38 (34.5%) patients after anesthesia induction. More patients in group O had hemodynamic instability (47.9% vs. 24.2%, p = 0.009) than in group N. The mean postoperative length of stay in the hospital was 10.64 ± 3.01 days, and most of the patients made an uneventful postoperative recovery.ConclusionsAnesthetic management for myxoma resection can be composed by assessing the myxoma, particularly the echocardiography evaluation and preventing cardiovascular instability. Typically, tricuspid or mitral valve with obstruction is a premier ingredient in anesthetic management.

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Section: Discussionmentioning

confidence: 89%

Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysis

Qi¹,

Yu²,

Yang³

et al. 2023

Front. Cardiovasc. Med.

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“…In contrast to left atrial myxomas, right-sided atrial myxomas tend to be asymptomatic until relatively late in their development. One study demonstrated that right atrial myxomas are only symptomatic when 7 cm or greater, corresponding to around twice the size of when left atrial myxomas become symptomatic [ 6 ]. A right atrial tumor can obstruct the flow of blood through the tricuspid valve, leading to tricuspid stenosis and right heart failure.…”

Section: Discussionmentioning

confidence: 99%

Rare Case of 6 cm Right Atrial Myxoma in Patient with Synchronous Endometrial Adenocarcinoma

Altujjar

Zaiem

Sheehan

et al. 2021

Case Reports in Cardiology

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“…[ 9 ] Echocardiography is a widely accepted approach for the detection of atrial mass. [ 8 ] But the nature of atrial mass could not be identified by routine echocardiography. In addition, the incidence of right heart thrombus with similar appearance to atrial myxoma is quite low according to the study of the European Working Group on Echocardiography in 1989.…”

Section: Discussionmentioning

confidence: 99%

A rare myxoma-like right atrial thrombus causing syncope

Yang¹,

Gu²

2018

Medicine

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Rationale:Syncope is a complicated clinical condition involving various diseases. Syncope due to myxoma-like right atrial thrombus is rarely seen in patient without structural heart disease.Patient concerns:A 61-year-old ambulant old male visited our emergency department for sudden syncope.Diagnoses:After the exclusion of neurological and coronary diseases, a right atrial block mass with a stalk connected to the atrial septum was accidentally found by echocardiography. Pulmonary embolism was subsequently revealed by computed tomographic pulmonary angiography. Atrial myxoma was initially suspected and surgical removal was conducted. Surprisingly, histological examination showed that the pedicled block mass was actually thrombus.Interventions:The myxoma-like right atrial thrombus and the emboli in the bilateral pulmonary trunks were resected. This patient received anticoagulant treatment with warfarin for 6 months additionally.Outcomes:The patient was successfully discharged and being continually followed.Conclusion:This patient had a past medical history of right femoral neck fracture, which might be responsible for the formation of the myxoma-like right atrial thrombus. We should always consider echocardiography examination in syncope patient at risk of thrombus formation.

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Right Atrial Myxoma with Pulmonary Artery Hypertension: Role of Transesophageal Echocardiography in Detection of Cause and Perioperative Management

Cited by 5 publications

References 22 publications

Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysis

Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysis

Rare Case of 6 cm Right Atrial Myxoma in Patient with Synchronous Endometrial Adenocarcinoma

A rare myxoma-like right atrial thrombus causing syncope

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