Experiences of Tumor Thrombi Removal in the Inferior Vena Cava and the Right Atrium upon Cardiopulmonary Bypass / 日本心臓血管外科学会雑誌

ABSTRACT

Between 1988 and 1992, we experienced 4 cases of removal of renal or hepatic cell carcinoma tumor thrombi extending into the inferior <i>vena cava</i> and the right atrium, under cardiopulmonary bypass. We operated on 3 cases using profound hypothermia and circulatory arrest, and 1 case using moderate hypothermia and the Pringle maneuver. One case developed acute massive pulmonary embolism followed by cardiac arrest during the procedure of freeing the inferior <i>vena cava</i> and died on the second postoperative day due to low output syndrome. The postoperative courses of the other 3 cases were uneventful, and there was no major complication due to surgery. They were discharged and enjoyed normal daily lives. Two cases died due to recurrence of the tumor, 6 and 7 months after the operation, respectively. The merits and demerits of these two surgical methods were discussed. Appropriate selection of these methods and subjects allows safe and complete excision of tumor thrombi with satisfactory operative results.