Left atrial appendage myxoma an intraoperative diagnostic dilemma. | ||||
| The Egyptian Journal of Cardiothoracic Anesthesia | ||||
| Articles in Press, Accepted Manuscript, Available Online from 19 May 2025 | ||||
| Document Type: Case reports | ||||
| DOI: 10.21608/ejca.2024.269573.1000 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Kiran Kishor Pisekar   1; Hemang Gandhi2; Abhishek Verma2
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| 1U N mehta institute of cardiology and research centre | ||||
| 2UNMICRC | ||||
| Abstract | ||||
| Background Cardiac tumours are rare, of which tumour arising from left atrial appendage is the rarest of the entity. Cardiac tumours pose a unique challenge to the anesthesiologist as they can be complicated with obstruction, arrhythmia or embolization. Case 57 year old female posted for cardiac tumour excision under general anaesthesia. Routine induction and maintenance of anaesthesia done as per Institutional protocol. Tranesophageal echocardiography was suggestive of intracardiac mass arising from left atrial atrial appendage protruding in to the left ventricle through the mitral valve in diastole causing gradient across the mitral valve measuring 54* 29 cm in at end systole and 36 * 27 cm at end diastole. We could differentiate the tumour from thrombus as it was, heterogeneous, pedunculated and there was change in size during various phases of cardiac cycle. Histopathology confirmed the diagnosis of myxoma. Tumour induction done on cardiopulmonary bypass. Pathological examination was suggestive of myxoma. Conclusion Though rare, left atrial appendageal tumour can be encountered in a clinical practice and should be differentiated from the thrombus. Anaesthesia management can be challenging as it can mimic stenotic lesions. TEE is an essential tool intraoperatively for management of such patients. | ||||
| Keywords | ||||
| LA appendage; myxoma; cardiac tumours; cardiac surgery; TEE | ||||
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