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Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute
Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute

Journal of Health and Medical Sciences

ISSN 2622-7258

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open access

Published: 17 December 2022

Anaesthetic Management of Patient with Left Atrial Myxoma, Coronary Artery Disease 3 Vessels Disease, and Parkinson’s Disease

Hana Nur Ramila, Adwitya Darmesta Gandhi N, Reza Widianto Sudjud

University of Padjadjaran, Hasan Sadikin General Hospital Bandung, Indonesia

journal of social and political sciences
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Pages: 97-104

Keywords: Anesthetic Management, CAD 3VD, Cardiopulmonary Bypass, Myxoma, Parkinson’s Disease


Myxomas are the most common primary benign intracavitatory tumour with the incidence of 0.5 per million populations. Myxomas account for 0.3% of all cardiac surgeries performed. Clinically, they are characterized by a triad of embolisation, obstruction of blood flow, and constitutional symptoms (Goodwin’s triad). Meanwhile Parkinson's disease is a degenerative neurologic disorder caused by degeneration of nerve cells in the substantia nigra causing weakness motor coordination. Symptoms include tremor, bradykinesia, rigidity, and postural instability. Achieving a satisfactory hemodynamic performance is the primary objective in the management of cardiac surgery patient. Optimal cardiac function ensures adequate perfusion and oxygenation of other organ systems (in particular vital organs) and improves the chances for an uneventful recovery from surgery. A 61-year old female diagnosed with Coronary Artery Disease 3 Vessel Disease (CAD 3 VD), Parkinson’s disease, and left atrial myxoma was brought to the emergency department with dyspnea. The patient has undergone angiography and the echocardiography result was LVEF 59% with global normokinetic, LA myxoma causing non-significant mitral flow. LA myxoma excision under general anaesthesia on CPB was planned. Balanced general anaesthesia on cardiopulmonary bypass forms the basis of Anaesthetic management of Cardiac myxomas. However specific individual considerations will have to be made regarding drugs, doses, regional anaesthetic choices, anticoagulation and post-operative management. There is no simple anesthetic technique for patients with Parkinson’. Therefore, careful preoperative assessment, administration of drugs during and after anesthesia, as well as avoiding agents that are known to trigger Parkinson's symptoms is a major factor in reducing postoperative morbidity and mortality.


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