Key result
Beating-heart cavoatrial thrombectomy on normothermic CPB enables metastasis-free survival at 4 years.
Case Report (n=1)
No
Demonstrates the feasibility and 4-year metastasis-free survival of synchronous radical nephrectomy and Level IV cavoatrial tumor thrombectomy performed under normothermic cardiopulmonary bypass on a beating heart.
Formation of tumor thrombus is an occasional manifestation of renal cell carcinoma (RCC). Intravascular invasion of the renal vein and thereafter the inferior vena cava (IVC) might in very rare cases extend into the cardiac chambers. The subtle course and symptoms of such cases alongside with the engagement of vital anatomical structures marks them as a diagnostic and therapeutic challenge. Aggressive surgical intervention has proven to be critical for survival rates in such cases; however total synchronous resection remains a challenge for the surgical team and a debate for the medical community. Following we report the case of a 66-year-old male who was diagnosed with a RCC of the right kidney accompanied by a tumor thrombus extending into the right atrium, after he suffered a presyncope episode. The patient underwent a radical en bloc nephrectomy and tumor thrombectomy under extracorporeal circulation with beating heart.
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Mavrigiannaki et al. (2018) conducted a case report in Renal cell carcinoma of the right kidney with Level IV cavoatrial tumor thrombus extending into the right atrium (n=1). Radical en bloc nephrectomy and cavoatrial tumor thrombectomy under normothermic extracorporeal circulation and beating heart was evaluated on Survival and freedom from metastasis.
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