Emergency cardiopulmonary bypass and pulmonary artery thrombectomy successfully treated massive intraoperative pulmonary artery tumor embolism in a 75-year-old patient, yielding complete recovery.
Case Report (n=1)
Can emergency cardiopulmonary bypass and pulmonary artery thrombectomy successfully rescue a patient with massive intraoperative pulmonary artery tumor embolism during RCC surgery?
Emergency cardiopulmonary bypass and pulmonary artery thrombectomy can successfully rescue patients experiencing massive intraoperative pulmonary artery tumor embolism and cardiac arrest during RCC surgery.
ABSTRACT Introduction Intraoperative tumor thrombus embolization during renal cell carcinoma (RCC) surgery with inferior vena cava (IVC) tumor thrombus is a rare but potentially fatal complication. We report successful emergency cardiac surgery for massive pulmonary artery tumor embolism. Case Presentation A 75‐year‐old female with left RCC and IVC tumor thrombus underwent radical nephrectomy. Pre‐existing left pulmonary artery tumor embolism was noted preoperatively. During IVC manipulation, the tumor thrombus dislodged and migrated through the right heart to completely occlude the right pulmonary artery, causing cardiac arrest. Through multidisciplinary collaboration, nephrectomy was completed under cardiac massage, followed by emergency cardiopulmonary bypass and pulmonary artery thrombectomy. The patient recovered completely without neurological sequelae. Conclusion This case demonstrates the critical importance of preoperative risk assessment, intraoperative transesophageal echocardiography monitoring, and immediate multidisciplinary decision‐making in managing this life‐threatening complication. The “double hit” mechanism of pre‐existing and acute pulmonary embolism significantly worsened the clinical course.
Kijima et al. (Sun,) conducted a case report in Renal cell carcinoma with IVC tumor thrombus and intraoperative pulmonary artery tumor embolism (n=1). Emergency cardiopulmonary bypass and pulmonary artery thrombectomy was evaluated on Patient recovery. Emergency cardiopulmonary bypass and pulmonary artery thrombectomy successfully treated massive intraoperative pulmonary artery tumor embolism in a 75-year-old patient, yielding complete recovery.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: