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Ann Card Anaesth. 2018 Oct-Dec;21(4):430-432. doi: 10.4103/aca.ACA_233_17.

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

Author information

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.

Abstract

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.

KEYWORDS:

Cardiothoracic surgery; extracorporeal membrane oxygenation; pediatric oncology; right atrium tumor

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