Extracorporeal Cardiopulmonary Resuscitation due to Left Atrial Myxoma With Severe Pulmonary Hypertension: A Challenging Combination
Abstract
Background: Myxomas are the most common primary cardiac tumors. Presentation as sudden cardiac death is uncommon. Management of patients on circulatory support with severe pulmonary hypertension (PH) is challenging.
Case summary: A 55-year-old woman was diagnosed with a giant left atrial myxoma. She experienced cardiac arrest requiring extracorporeal cardiopulmonary resuscitation (ECPR). Management of combined pre- and postcapillary PH was the key to the weaning of circulatory support.
Discussion: To our knowledge, this is the first reported case of ECPR owing to an atrial myxoma. It suggests that ECPR may be considered as a bridge to surgery in sudden cardiac death in atrial myxoma, although precapillary PH may complicate weaning from circulatory support.
Take-home messages: ECPR can be a lifesaving strategy in atrial myxoma. Management with circulatory support can be challenging owing to precapillary PH after tumor resection. Pulmonary vasodilators can play a key role in these patients.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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