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Perioperative management of critical right ventricular inflow obstruction from right atrial rhabdomyoma


1 Manchester Academic Health Science Centre, Cardiothoracic Anaesthesia and Intensive Care, Manchester University, Manchester University NHS Foundation Trust, Manchester, UK; Department of Cardiac Anaesthesia, Apollo Hospital, New Delhi, India
2 Department of Cardiac Anaesthesia, Apollo Hospital, New Delhi, India
3 Manchester Academic Health Science Centre, Cardiothoracic Anaesthesia and Intensive Care, Manchester University, Manchester University NHS Foundation Trust, Manchester, UK; Department of Anaesthesiology and Intensive Care, The Prince Charles Hospital, The University of Queensland, Critical Care Research Group, Brisbane, Australia; Department of Anaesthesiology and Intensive Care, Philipps University, Marburg, Germany

Correspondence Address:
Rahul Norawat
Department of Cardiothoracic Anaesthesia, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M139WL, United Kingdom

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_233_17

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Year : 2018  |  Volume : 21  |  Issue : 4  |  Page : 430-432

 

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Rhabdomyoma is the most common cardiac tumor in infancy and commonly located in the ventricles causing outflow obstruction or arrhythmias. We report a rare pediatric (7 month old) case of a right atrial rhabdomyoma presenting with severe cyanosis and low cardiac output from significant tricuspid inflow obstruction with right to left shunt across a stretched patent foramen ovale. We present an emergency cardiac surgery for right atrial tumor resection, and the management of separating the patient with failing right ventricle from cardiopulmonary bypass using a Glenn shunt, since extracorporeal membrane oxygenation (ECMO) or nitric oxide was not available.






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1 Manchester Academic Health Science Centre, Cardiothoracic Anaesthesia and Intensive Care, Manchester University, Manchester University NHS Foundation Trust, Manchester, UK; Department of Cardiac Anaesthesia, Apollo Hospital, New Delhi, India
2 Department of Cardiac Anaesthesia, Apollo Hospital, New Delhi, India
3 Manchester Academic Health Science Centre, Cardiothoracic Anaesthesia and Intensive Care, Manchester University, Manchester University NHS Foundation Trust, Manchester, UK; Department of Anaesthesiology and Intensive Care, The Prince Charles Hospital, The University of Queensland, Critical Care Research Group, Brisbane, Australia; Department of Anaesthesiology and Intensive Care, Philipps University, Marburg, Germany

Correspondence Address:
Rahul Norawat
Department of Cardiothoracic Anaesthesia, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M139WL, United Kingdom

Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_233_17

Rights and Permissions

Rhabdomyoma is the most common cardiac tumor in infancy and commonly located in the ventricles causing outflow obstruction or arrhythmias. We report a rare pediatric (7 month old) case of a right atrial rhabdomyoma presenting with severe cyanosis and low cardiac output from significant tricuspid inflow obstruction with right to left shunt across a stretched patent foramen ovale. We present an emergency cardiac surgery for right atrial tumor resection, and the management of separating the patient with failing right ventricle from cardiopulmonary bypass using a Glenn shunt, since extracorporeal membrane oxygenation (ECMO) or nitric oxide was not available.






[FULL TEXT] [PDF]*


        
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