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

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Yun-tai Yao¹  Da-xuan Yang¹  Xiao-lu Yu²  Jun-ping Chen³  Wei Qi³  Xu-kai Hu³ 

[1] Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China;Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China;Department of Gynecology, Ningbo Women and Children’s Hospital, Zhejiang, China;Department of Anesthesiology, Ningbo No.2 Hospital, Zhejiang, China;Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China;

关键词: cardiac myxoma;    myxoma resection;    anesthetic management;    mitral valve obstruction;    hemodynamic instability;   

DOI  :  10.3389/fcvm.2023.1126822

 received in 2022-12-18, accepted in 2023-04-12,  发布年份 2023

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

Unknown   
© 2023 Qi, Yu, Yang, Hu, Chen, Yao and the Evidence in Cardiovascular Anesthesia (EICA) Group.