Extracorporeal Cardiopulmonary Resuscitation due to Left Atrial Myxoma With Severe Pulmonary Hypertension

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.