Case Report Korean J Anesthesiol 2011 December 61(6): 528-532 http://dx.doi.org/10.4097/kjae.2011.61.6.528 Anesthetic experiences of myxoma removal surgery in two patients with Carney complex -A report of two cases- Young Mi Kang, and Yoon Hee Kim Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon, Korea Carney complex is an autosomal dominant disorder that occurs due to a mutation in PRKAR1A, which encodes protein kinase A. The clinical features are multiple endocrine gland neoplasms, skin tumors, pigmented skin lesions, myxomas, and schwannomas. In Carney complex, the cardiac myxoma is a common co-morbidity. It occurs in multiples, during young age, regardless of gender and cardiac chamber and is known to recur frequently. Therefore there are high risks of adhesion and massive bleeding due to repeated surgeries. Such surgical risks account for over 50% of disease-specific mortality of Carney complex patients. Here, we present anesthetic experiences of myxoma removal surgery in two patients with Carney complex. (Korean J Anesthesiol 2011; 61: 528-532) Key Words: Anesthesia, Carney complex, Myxoma. Carney complex is an autosomal dominant disorder that occurs due to a mutation in the gene subunit PRKAR1A, which encodes protein kinase A. Clinical features are multiple endo- crine tumor, skin tumor, pigmented skin lesions, myxomas, and schwannomas [1,2]. Carney complex can cause multiple endocrine dysfunctions in the pituitary gland, thyroid gland, adrenal gland, and testicular gland and induce difficult airway from acromegaly [3,4] and hemodynamic instability from adrenal gland dysfunction [1,5,6]. Cardiac myxomas are also commonly accompanied [1,7,8]. There are increasing risks of cardiac blood flow obstruction, arrhythmia, embolization, and sudden death depending on the size and location of the myxoma [7-9]. Compared to general myxomas, this differs by having no link to sex or cardiac chambers, usually appearing during younger age and in multiple, with frequent relapses and a tendency to increase rapidly in size [7,8]. Thus most cases require immediate surgical treatment after diagnosis, which has led to high risks of adhesion and massive bleeding due to repeated surgeries, and such surgical risks account for over 50% of disease-specific mortality of Carney complex patients [1,2]. The authors present the anesthetic experiences of cardiac myxoma removal of two Carney complex patients with multiple endocrine tumors and multiple cardiac myxomas. Received: April 28, 2011. Revised: 1st, July 8, 2011; 2nd, July 19, 2011. Accepted: July 19, 2011. Corresponding author: Yoon Hee Kim, M.D., Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, 33, Munhwaro, Jung-gu, Daejeon 301-721, Korea. Tel: 82-42-280-7840, Fax: 82-42-280-7968, E-mail: yhkim0404@cnu.ac.kr CC This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright ⓒ the Korean Society of Anesthesiologists, 2011 www.ekja.org