Intraoperative heparin resistance, severe tricuspid valve regurgitation and acute right ventricular failure following large right atrial myxoma excision in a post corona virus disease -2019 patient -- A case report

Abstract

INTRODUCTION Tricuspid valve regurgitation (TR) and severe right ventricular (RV) systolic dysfunction may appear acutely after right atrial (RA) myxoma excision. Covid-19 infection may have a role in production of Heparin resistance. METHODS A case of post covid-19 infected RA myxoma was operated by surgical excision develop severe TR and acute right ventricular systolic dysfunction postoperatively for which Tricuspid valve ring annuloplasty was performed and RV was supported on Cardiopulmonary bypass (CPB). RESULTS RV dysfunction did not improve leading to cardiac arrest and death. Conclusion • Excision of RA myxoma can unmask the severe TR and severe RV systolic dysfunction not responsive to TV ring annuloplasty. • COVID-19 infection might have a role in production of heparin resistance. KEY WORDS: Covid-19, tricuspid annuloplasty, intraoperative heparin resistance, RV Dysfunction, cardiopulmonary bypass.