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J Thorac Cardiovasc Surg 2009;137:e42-e44
© 2009 The American Association for Thoracic Surgery

Brief Communication

Modified perfusion technique for patients with renal cell carcinoma infiltrating the inferior vena cava

Gianluigi Bisleri, MDa,*, Paolo Piccoli, MDa, Sergio Cosciani Cunico, MDb, Claudio Muneretto, MDa

a Division of Cardiac Surgery, University of Brescia Medical School, Brescia, Italy
b Division of Urology, University of Brescia Medical School, Brescia, Italy

Received for publication January 31, 2008; accepted for publication February 10, 2008.

* Address for reprints: Gianluigi Bisleri, MD, Cardiochirurgia SSVD–Spedali Civili, P.le Spedali Civili, 1, 25123 Brescia, Italy. (Email: gianluigi.bisleri@gmail.com).

The first 20% of the full text of this article appears below.

The surgical removal of renal cell carcinoma with thrombus extension in the inferior vena cava (IVC) and right atrium has been extensively described by means of a combined abdominal and thoracic approach with the aid of cardiopulmonary bypass and deep hypothermic circulatory arrest.1-3Go

In an effort to further reduce the potential complications of such a perfusion technique (especially in terms of postoperative bleeding), we developed a simple modification of the circulatory support to provide continuous antegrade perfusion of the supra-aortic vessels during systemic circulatory arrest with moderate hypothermia.

Clinical Summary

A 71-year-old woman was admitted to the Division of Urology at the University of Brescia Medical School after prolonged hematuria. Multislice abdominal computed tomography evaluation evidenced a huge neoplastic plurifocal mass in the left kidney, with a neoplastic thrombus infiltrating the main left renal vein and the IVC close to the suprahepatic veins. The diameter of the mass in the IVC at its maximum was . . . [Full Text of this Article]






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