Anesthetic management of a patient with asymptomatic atrial myxoma for hernia repair

Left atrial myxomas are rare cardiac tumours. When diagnosed, these need to be surgically excised as early as possible as these are known to cause dangerous complications, e.g. intracardiac obstruction and embolism. But when presented as an incidental finding on routine echocardiography in a patient presenting with epigastric hernia it creates a clinical dilemma as to which surgery should be performed first. We present one such case of left atrial myxoma in a 58 year old male patient, who underwent hernioplasty under general anesthesia with thoracic epidural analgesia

A can’t ventilate, can’t intubate and can’t do tracheostomy situation

Difficult airway scenarios may result in significant morbidity and mortality and require prompt intervention. American Society of Anesthesiologists1 and Difficult Airway Society of UK have published guidelines for the management of difficult airway and both end in the management of can't intubate can't ventilate [CICV] situation. We present an unusual case of a collapsed anterior wall of trachea resulting in a situation of "can't intubate, can't ventilate and can't do tracheostomy". A desperate use of a rigid bronchoscope resulted in successful intubation by lifting the collapsed tracheal rings and saved the patient