Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysis
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 wa...
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| Format: | Article |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1126822/full |
| _version_ | 1797838641879318528 |
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| author | Wei Qi Wei Qi Xiao-lu Yu Xiao-lu Yu Da-xuan Yang Xu-kai Hu Xu-kai Hu Jun-ping Chen Jun-ping Chen Yun-tai Yao the Evidence in Cardiovascular Anesthesia (EICA) Group |
| author_facet | Wei Qi Wei Qi Xiao-lu Yu Xiao-lu Yu Da-xuan Yang Xu-kai Hu Xu-kai Hu Jun-ping Chen Jun-ping Chen Yun-tai Yao the Evidence in Cardiovascular Anesthesia (EICA) Group |
| author_sort | Wei Qi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-09T15:44:10Z |
| format | Article |
| id | doaj.art-60c087b8f8b24c49a8fe76af8b6c9942 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-09T15:44:10Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-60c087b8f8b24c49a8fe76af8b6c99422023-04-27T05:04:26ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-04-011010.3389/fcvm.2023.11268221126822Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysisWei Qi0Wei Qi1Xiao-lu Yu2Xiao-lu Yu3Da-xuan Yang4Xu-kai Hu5Xu-kai Hu6Jun-ping Chen7Jun-ping Chen8Yun-tai Yao9the Evidence in Cardiovascular Anesthesia (EICA) GroupDepartment of Anesthesiology, Ningbo No.2 Hospital, Zhejiang, ChinaDepartment of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Gynecology, Ningbo Women and Children’s Hospital, Zhejiang, ChinaDepartment of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Anesthesiology, Ningbo No.2 Hospital, Zhejiang, ChinaDepartment of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Anesthesiology, Ningbo No.2 Hospital, Zhejiang, ChinaDepartment of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaBackgroundMyxomas 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.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1126822/fullcardiac myxomamyxoma resectionanesthetic managementmitral valve obstructionhemodynamic instability |
| spellingShingle | Wei Qi Wei Qi Xiao-lu Yu Xiao-lu Yu Da-xuan Yang Xu-kai Hu Xu-kai Hu Jun-ping Chen Jun-ping Chen Yun-tai Yao the Evidence in Cardiovascular Anesthesia (EICA) Group Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysis Frontiers in Cardiovascular Medicine cardiac myxoma myxoma resection anesthetic management mitral valve obstruction hemodynamic instability |
| title | Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysis |
| title_full | Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysis |
| title_fullStr | Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysis |
| title_full_unstemmed | Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysis |
| title_short | Anesthetic management of patients undergoing cardiac myxoma resection: a single-center retrospective analysis |
| title_sort | anesthetic management of patients undergoing cardiac myxoma resection a single center retrospective analysis |
| topic | cardiac myxoma myxoma resection anesthetic management mitral valve obstruction hemodynamic instability |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1126822/full |
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