| Anesthesia for Excision of Atrial Myxoma. |
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Kyung Suk Chung, Sou Ouk Bang, Hung Kun Oh |
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Department of Anesthesiology, Yonsei University, College of Medicine, Seoul, Korea. |
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| Abstract |
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Removal of a left atrial myxoma using extracorporeal circulation was successfully performed first in 1954 by Craford. The problems of anesthesia for resection of atrial myxoma were the hemodynamic alterations, embolisation and valvular obstruction produced by tumor size and location, conduction defects due to myocardial invasion and anesthetic and operative procedures. Thus we have mad clinical analysis of 13 cases receiving anesthesia performend from 1976 to 1983 at Severance Hospital, Yonsei University College of Medicine. The results of clinical analysis are as follows: 1) Atrial myxomas were located(in the) in the lefte atrium except for 1 case. 2) Preoperatively most of these case showed congestive heart failure, cardiomegaly, arrhythmia and increased right atrial, pulmonary arterial and pulmonary capillary wedge pressures. 3) As premedicantes, one of the sedatives and a mild tranquilizer were given in all cases, atropine in about one third and triflupromaxine in about one half of the cases. 4) Anesthesia was induced with thiopental, morphine, midazolam, flunitrozepam and intubated after succinylchoilne or pancuronfum and maintained in the usual manner. 5) Myoxamas were resected during cardiopulmonary bypass and one case had to have a mitral value replacement. 6) The average duration of anesthesia and bypass was 372.14+/-42.0 and 104+/-12.9min. No mortality occurred. From the above results, it can be concluded that the understanding of the pathophysiology and the hemodynamic changes before anesthesia are important for safe anesthesia. |
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