scholarly journals Tumour Thrombi in the Suprahepatic Inferior Vena Cava: The Cardiothoracic Surgeons’ View

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Aristotle D. Protopapas ◽  
Hutan Ashrafian ◽  
Thanos Athanasiou
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Inferior Vena ◽  
Blood Product ◽  
Transitional Cell ◽  
Vena Cava ◽  
Case Series ◽  
Surgical Incisions ◽  
Suprahepatic Inferior Vena Cava ◽  
Anaesthetic Time

Background. Retroperitoneal tumours propagate intrathoracic caval tumour thrombi (ICTT) of which we consider two subgroups: ICTT-III (extracardiac) and ICTT-IV (intracardiac). Methods. Case series review. Results. 29 series with 784 patients, 453 with extracardiac and 331 with intracardiac ICTT. Average age was 59 years. 98% of the tumours were RCC, 1% adrenal and Wilms’ tumours, and 1% transitional cell carcinomas. The prevalent incision was rooftop with or without sternotomy. Mortality was 10% (5% for ICTT-III, 15% for ICTT-IV). Morbidity was 56% (36% for ICTT-III, 64% for ICTT-IV) and reoperation for bleeding was the commonest complication (14%). Mean Blood loss was 2.6 litres for ICTT-III and 3.7 litres for ICTT-IV. Mean blood product use was 2.4 litres for ICTT-III and 3.5 litres for ICTT-IV. Operative and anaesthetic times exceeded 5 hours. Hospital stay averaged 13 days. Variations in perioperative care included preoperative embolisation, perioperative transoesophageal echo, surgical incisions, and extracorporeal circulation. Brief Summary. Surgery for ICTT has high transfusion, operating/anaesthetic time, and in-hospital stay requirements, and intracardiac ICTT also attract higher risk. Preoperative tumour embolisation is controversial. The cardiothoracic team offers proactive optimisation of blood loss and preemptive management of intracardiac thrombus impaction: we should always be involved in the management the ICTT.

scholarly journals Obstruction of the inferior vena cava following bicaval orthotopic heart transplantation: a case series

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Anas Abudan ◽  
Brent Kidd ◽  
Peter Hild ◽  
Bhanu Gupta
Keyword(s):  
Inferior Vena Cava ◽  
Heart Transplantation ◽  
Inferior Vena ◽  
Rare Complication ◽  
Vena Cava ◽  
Case Series ◽  
Transoesophageal Echocardiography ◽  
Right Atrial ◽  
Orthotopic Heart Transplantation ◽  
Eustachian Valve

Abstract Background Inferior vena cava (IVC) obstruction is a rare complication of orthotopic heart transplantation (OHT) and is unique to bicaval surgical technique. The clinical significance, diagnosis, complications, and management of post-operative IVC anastomotic obstruction have not been adequately described. Case summary Two patients with end-stage heart failure presented for bicaval OHT. Post-operative course was complicated with shock refractory to fluid resuscitation and inotropic/vasopressor support. Obstruction at the IVC-right atrial (RA) anastomosis was diagnosed on transoesophageal echocardiography (TOE), prompting emergent reoperation. In both cases, a large donor Eustachian valve was found to be restricting flow across the IVC-RA anastomosis. Resection of the valve resulted in relief of obstruction across the anastomosis and subsequent improvement in haemodynamics and clinical outcome. Discussion Presumably rare, we present two cases of IVC obstruction post-bicaval OHT. Inferior vena cava obstruction is an under-recognized cause of refractory hypotension and shock in the post-operative setting. Prompt recognition using TOE is crucial for immediate surgical correction and prevention of multi-organ failure. Obstruction can be caused by a thickened Eustachian valve caught in the suture line at the IVC anastomosis, which would require surgical resection.

Stent Graft Placement in the Top-Down Direction for Treating Traumatic Intra-Abdominal Suprahepatic Inferior Vena Cava Rupture: A Case Report

2021 ◽  
pp. 152660282110250
Author(s):  
Yun Chul Park ◽  
Hyoung Ook Kim ◽  
Nam Yeol Yim ◽  
Byung Chan Lee ◽  
Chan Park ◽  
...  
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Stent Graft ◽  
Inferior Vena ◽  
Vena Cava ◽  
Endovascular Management ◽  
Top Down ◽  
Life Threatening ◽  
The Right ◽  
Suprahepatic Inferior Vena Cava

Purpose The treatment of suprahepatic inferior vena cava (IVC) ruptures results in high mortality rates due to difficulty in performing the surgical procedure. Here, we present a case of successful endovascular management of a life-threatening suprahepatic IVC rupture with top-down placement of a stent graft. Case Report A 33-year-old woman was involved in a traffic accident and presented to our emergency department due to unstable hemodynamics after blunt abdominal wall trauma. Computed tomography (CT) revealed massive extravasation of contrast agent from the suprahepatic IVC, which suggested traumatic suprahepatic IVC rupture. To seal the IVC, to salvage major hepatic veins, and to prevent migration of the stent graft into the right side of the heart after placement, an aortic cuff with a proximal hook was introduced in a top-down direction via the right internal jugular vein. After closure of the injured IVC, the patient’s hemodynamics improved, and additional laparotomy was performed. After 3 months of trauma care, the patient recovered and was discharged. Follow-up CT after 58 months showed a patent stent graft within the IVC. Conclusion Endovascular management with top-down placement of a stent graft is a viable option for emergent damage control in patients with life-threatening hemorrhage from IVC rupture.

scholarly journals Renal primitive neuroectodermal tumour: Case series and brief review

2014 ◽  
Vol 8 (3-4) ◽  
pp. 241
Author(s):  
Tadeusz Kroczak ◽  
Rajan Sharda ◽  
Darrel Drachenberg ◽  
Turki Al-Essawi
Keyword(s):  
Literature Review ◽  
Inferior Vena Cava ◽  
Primitive Neuroectodermal Tumor ◽  
Inferior Vena ◽  
Vena Cava ◽  
Case Series ◽  
Primitive Neuroectodermal Tumour ◽  
Pathologic Features ◽  
Rare Malignancy ◽  
Pathologic Analysis

Renal primitive neuroectodermal tumor is a rare malignancy. These tumours rarely present with caval involvement. We report 2 cases of primitive neuroectodermal tumours (PNETs) with inferior vena cava involvement. The initial presentation and outcomes differed significantly. The diagnosis was confirmed using histologic and pathologic analysis. We present a brief literature review and an outline of typical clinical and pathologic features of renal PNETs.

scholarly journals Transitional Cell Carcinoma of the Renal Pelvis with Extension into the Inferior Vena Cava: A Report of Two Cases

2003 ◽  
Vol 19 (7) ◽  
pp. 362-366 ◽  
Author(s):  
Yung-Shun Juan ◽  
Mei-Yu Jang ◽  
Jung-Tsung Shen ◽  
Yii-Her Chou ◽  
Chun-Hsiung Huang ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Pelvis ◽  
Inferior Vena ◽  
Transitional Cell ◽  
Vena Cava

Reconstruction of a total avulsion of the hepatic veins and the suprahepatic inferior vena cava secondary to blunt thoracoabdominal trauma

2010 ◽  
Vol 396 (2) ◽  
pp. 261-265 ◽  
Author(s):  
Daniel Kaemmerer ◽  
Wolfgang Daffner ◽  
Martin Niwa ◽  
Thomas Kuntze ◽  
Merten Hommann
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Hepatic Veins ◽  
Suprahepatic Inferior Vena Cava
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