Extracorporeal Cardiopulmonary Resuscitation due to Left Atrial Myxoma With Severe Pulmonary Hypertension: A Challenging Combination.

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.