TY - JOUR
AB - AbstractThis study reviews eight patients, 39-63 years old, with tumor-relatedobstruction of the inferior vena cava (IVC) extending into the right atrium(n = 5) and ventricle (n = 3). Five patients suffered from renal cellcarcinoma, 3 from sarcomatous disease. The general approach was a mediansternotomy and laparotomy with hypothermic circulatory arrest (17.0-20.5degrees C; 23-46 min) in six patients, while in two patients, the IVC wasclamped sequentially under moderate hypothermia and extracorporealcirculation. Four patients had tumor infiltration of the IVC necessitatingpartial caval resection. In three, the IVC was reconstructed by fabricpatches or tubular prothesis. In one patient, the continuity of the IVC wasinterrupted permanently. Three patients underwent nephrectomy during thesame procedure, two before and one after IVC disobliteration. In onepatient each, pulmonary embolectomy and intrahepatic IVC stenting wereperformed. Two patients died early, one due to uncontrollable hemorrhagethe other due to non-cardiogenic pulmonary edema. Six patients weredischarged in good physical condition and are still alive at a meanfollow-up of 24 months. Five patients have since remained free ofrecurrence, one patient underwent three further surgical interventions forbone metastases. We feel that IVC desobliteration is feasible in selectedcases with extended tumor- related obstruction with an acceptable earlyrisk and late outcome.
TI - Tumor-related obstruction of the inferior vena cava extending into the right heart--a plea for surgery in deep hypothermic circulatory arrest
JF - European Journal of Cardio-Thoracic Surgery
DO - 10.1016/1010-7940(91)90122-Z
DA - 1991-12-01
UR - https://www.deepdyve.com/lp/oxford-university-press/tumor-related-obstruction-of-the-inferior-vena-cava-extending-into-the-amabUuPiH9
SP - 653
EP - 656
VL - 5
IS - 12
DP - DeepDyve
ER -