Large myxoma causing cardiac arrest during surgery
© The Author(s) 2015
Received: 14 September 2015
Accepted: 1 December 2015
Published: 29 December 2015
The patient was a 67-year-old woman with a history of worsening dyspnea over several months. Cardiac echocardiography showed a large, mobile left atrial myxoma. Emergency surgery was performed. Cardiac arrest occurred during repositioning of the heart to cannulate the inferior vena cava and transesophageal echocardiography revealed the large myxoma obstructing the left ventricle. Cardiopulmonary bypass was initiated and spontaneous heartbeat returned shortly afterward. Changing myxoma position and sudden mitral orifice obstruction must be considered in these cases and once the diagnosis is made, patients should be operated on as early as possible.
Large myxomas can obstruct the mitral valve and lead to sudden death . We report a patient with a large left atrial myxoma that caused cardiac arrest during extirpation surgery.
Large left atrial myxomas have caused complete obstruction of the mitral valve orifice, resulting in sudden death . Simply changing body position can vary the extent of valvular obstruction . Changing myxoma position and sudden mitral orifice obstruction must be considered in these cases and once the diagnosis is made, patients should be operated on as early as possible. The patient in our case developed cardiac arrest soon after aortic and superior vena caval cannulas were inserted. Therefore, cardiopulmonary bypass could be established immediately, thereby resulting in the rapid recovery of blood flow to the coronary artery and a spontaneous heartbeat. Because cardiac arrest can happen at any time, stand-by percutaneous cardiopulmonary support is ideal.
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