Essandoh Michael, Andritsos Michael, Kilic Ahmet, Crestanello Juan
The Ohio State University, Columbus, OH, USA
The Ohio State University, Columbus, OH, USA.
Semin Cardiothorac Vasc Anesth. 2016 Mar;20(1):104-9. doi: 10.1177/1089253215584194. Epub 2015 Apr 23.
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.
心脏黏液瘤占所有原发性心脏良性肿瘤的50%。这些肿瘤很少发生于右心房（RA；10%至20%），其瘤蒂常附着于房间隔。右心房黏液瘤可导致右心房扩大、心律失常、功能性三尖瓣狭窄、右心衰竭，以及灾难性的肺栓塞，从而导致心源性猝死。右心房黏液瘤患者的麻醉管理可能因黏液瘤的占位效应、前负荷限制以及心血管崩溃的可能性而变得复杂。包括超声心动图、计算机断层扫描和磁共振成像在内的多模态心脏成像有助于诊断、术前优化以及制定麻醉和手术计划。我们报告一例病例，强调多模态成像、充分的术前患者优化以及麻醉考虑因素在成功治疗一名患有8.3×4.7 cm巨大右心房黏液瘤患者中的重要性。
