The management of fast-track cardiac anesthesia in a patient with right atrial myxoma
Primer kalp tümörlerinin insidansı düşük olup, tüm kalp ameliyatlarının yalnızca %0.3’ünü oluştururlar. Atriyal miksomalar primer kalp tümörlerinin en sık görülen tipidir ve bunlar hızlı büyüdüklerinde yaşamı tehdit eden semptomlar gelişebilir. Pulmoner emboli ve infektif endokardit, sağ atriyal miksomanın nadir komplikasyonudur. Bu yazıda pulmoner emboli ve infektif endokardit ile komplike olmuş sağ atriyal miksomalı hastaya minimal invaziv koroner arter baypas greft cerrahisi sırasında uygulanan hızlı derlenme kardiyak anestezisi işlemi ve anestezi yönetimi sunuldu.
Sağ atriyal miksomalı bir hastada hızlı derlenme kardiyak anestezi uygulaması
The incidence of primary cardiac tumors is low, accounting for only 0.3% of all open cardiac operations. Atrial myxomas are the most common type of primary cardiac tumors, and they may progress to life-threatening symptoms when they enlarge rapidly. Both pulmonary embolism and infective endocarditis are rare complications of right atrial myxomas. In this article, we report the anesthetic management of a patient with right atrial myxoma complicated by pulmonary embolism and infective endocarditis who was treated surgically with a fast-track cardiac anesthesia procedure during minimally invasive coronary artery bypass graft surgery.
___
- 1. Leone S, dell’aquila G, Giglio S, Magliocca M, Maio P, Nigro FS, et al. Infected atrial myxoma: case report and literature review. Infez Med 2007;15:256-61.
- 2. Oshiumi M, Hashimoto K, Sasaki T, Takakura H, Hachiya T, Onoguchi K. Right atrial myxoma complicated with pulmonary embolism. Jpn J Thorac Cardiovasc Surg 2001;49:449-52.
- 3. Johns RA, Kron IL, Carey RM, Lake CL. Atrial myxoma: case report, brief review, and recommendations for anesthetic management. J Cardiothorac Anesth 1988;2:207-12.
- 4. Cheng DC, Karski J, Peniston C, Asokumar B, Raveendran G, Carroll J, et al. Morbidity outcome in early versus conventional tracheal extubation after coronary artery bypass grafting: a prospective randomized controlled trial. J Thorac Cardiovasc Surg 1996;112:755-64.
- 5. Reis J, Mota JC, Ponce P, Costa-Pereira A, Guerreiro M. Early extubation does not increase complication rates after coronary artery bypass graft surgery with cardiopulmonary bypass. Eur J Cardiothorac Surg 2002;21:1026-30.
- 6. Lee MC, Chen CH, Kuo MC, Kang PL, Lo A, Liu K. Isoflurane preconditioning-induced cardio-protection in patients undergoing coronary artery bypass grafting. Eur J Anaesthesiol 2006;23:841-7.
- 7. Lison S, Schill M, Conzen P. Fast-track cardiac anesthesia: efficacy and safety of remifentanil versus sufentanil. J Cardiothorac Vasc Anesth 2007;21:35-40.
- 8. Howie MB, Michelsen LG, Hug CC Jr, Porembka DT, Jopling MW, Warren SM, et al. Comparison of three remifentanil dose-finding regimens for coronary artery surgery. J Cardiothorac Vasc Anesth 2003;17:51-9.