Intraoperative Pulmonary Embolism During Right Atrial Mass Excision: A Case Report on Intraoperative Rescue TEE.

Intraoperative pulmonary embolism is a rare but life-threatening complication during cardiac surgeries involving right atrial masses. This case report details the successful management of a 62-year-old woman with a right atrial mass, utilizing transesophageal echocardiography (TEE). The patient, with a history of diabetes, hypertension, and coronary artery disease, presented with breathlessness. Preoperative echocardiography identified a mobile mass prolapsing through the tricuspid valve. Following anesthesia induction, embolization of the mass caused hemodynamic collapse, confirmed by intraoperative transesophageal echocardiography. Immediate surgery was modified to include pulmonary thrombectomy under deep hypothermic circulatory arrest, emphasizing transesophageal echocardiography critical role in guiding surgical decisions.