scholarly journals First Resection of a Cavoatrial Renal Tumor Thrombus in a Pediatric Patient in Central America Based on a Multistage Surgical Safety Strategy Combining Liver Transplant Techniques and Cardiac Surgery

2021 ◽  
pp. 47-55
Author(s):  
Edward Castro-Santa ◽  
Hellen Daniela Siles-Víquez ◽  
Karla Castro-Solano ◽  
Javier Brenes-González ◽  
María A. Matamoros
Keyword(s):  
Cardiac Surgery ◽  
Inferior Vena Cava ◽  
Pediatric Patient ◽  
Inferior Vena ◽  
Renal Tumor ◽  
Vena Cava ◽  
Surgical Safety ◽  
Chiari Syndrome ◽  
The Right ◽  
Safety Strategy

We herein report the challenging evaluation and planning process involved in performing the first successful surgical resection of a renal tumor with extensive inferior vena cava tumor thrombosis reaching the right atrium in a pediatric patient within the Central American region. In November 2018, the Oncology Department of the National Children’s Hospital in Costa Rica consulted our Center for Liver Transplantation and Hepatobiliary Surgery for the evaluation of a clinical case involving a 6-year-old female patient with progressive Budd-Chiari syndrome caused by a Wilms’ tumor of the right kidney with tumor thrombosis of the inferior vena cava reaching the right atrium. A multistage surgical safety strategy combining liver transplant techniques and cardiac surgery was thereafter designed and implemented, achieving complete excision of the tumor thrombus from the inferior vena cava with right nephrectomy. Postoperatively, the patient exhibited complete clinical resolution of Budd-Chiari syndrome and has remained tumor free with excellent quality of life while pursuing her second grade of primary school education 22 months after the successful implementation of this multistage surgical safety strategy. The combination of liver transplantation techniques and cardiac surgery based on a multistage surgical safety strategy minimized the occurrence of unexpected intraoperative events and allowed for complete renal tumor resection and level IV thrombectomy for the first time in a pediatric patient of a public health system in a developing country within the Central American region.

Recanalization and Reconstruction of a Chronically Occluded Inferior Vena Cava Through an Existing Transjugular Intrahepatic Portosystemic Shunt in the Setting of Budd-Chiari Syndrome

2021 ◽  
pp. 153857442110020
Author(s):  
Reza Talaie ◽  
Hamed Jalaeian ◽  
Nassir Rostambeigi ◽  
Anthony Spano ◽  
Jafar Golzarian
Keyword(s):  
Inferior Vena Cava ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Inferior Vena ◽  
Vena Cava ◽  
Portosystemic Shunt ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Chiari Syndrome ◽  
Intrahepatic Portosystemic Shunt ◽  
The Right

Budd-Chiari syndrome (BCS) results from the occlusion or flow reduction in the hepatic veins or inferior vena cava and can be treated with transjugular intrahepatic portosystemic shunt when hepatic vein recanalization fails.1-3 Hypercoagulable patients with primary BCS are predisposed to development of new areas of thrombosis within the TIPS shunt or IVC. This case details a patient with BCS, pre-existing TIPS extending to the right atrium, and chronic retrohepatic IVC thrombosis who underwent sharp recanalization of the IVC with stenting into the TIPS stent bridging the patient until his subsequent hepatic transplantation.

scholarly journals Large inferior vena cava tumor with cardiac extension revealed by venous thrombembolism in a patient with complete situs inversus: what are the odds?

2021 ◽  
Vol 31 (1) ◽  
pp. 85-89
Author(s):  
Diana-Andreea Roscaneanu ◽  
Ovidiu Mitu ◽  
Daniela Crisu ◽  
Radu-Stefan Miftode ◽  
Mihai Stefan Cristian Haba ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Situs Inversus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Diffi Cult ◽  
Occult Malignancy ◽  
Chiari Syndrome ◽  
Liver And Kidney ◽  
The Right ◽  
Complete Situs Inversus

Venous thromboembolism (VTE) can be the fi rst symptom of an occult malignancy in apparently healthy individual. Inferior vena cava (IVC) tumors are rare conditions but with negative prognosis. We present the case of a 57 year-old male patient, with complete situs inversus, diagnosed with hepatic cirrhotic disease and frequent decompensations, that was hospitalized for deep venous thrombosis (DVT) and ascites. Further imagistic investigations revealed a 22 cm tumor inside the IVC with consequent Budd-Chiari syndrome that was actually causing the liver and kidney disease, extending from the infrarenal level to the right atrium. After compensation, the patient was referred to a multidisciplinary surgical team. However, the management of such patients is very diffi cult, and the prognosis is altered. Possible IVC leiomyosarcoma are very rare and such vascular extension has been rarely reported.

scholarly journals Intrahepatic Cholangiocarcinoma Presenting as the Budd-Chiari Syndrome: A Case Report and Literature Review

2005 ◽  
Vol 19 (12) ◽  
pp. 723-728 ◽  
Author(s):  
Joanna K Law ◽  
Jenny Davis ◽  
Anne Buckley ◽  
Baljinder Salh
Keyword(s):  
Inferior Vena Cava ◽  
Intrahepatic Cholangiocarcinoma ◽  
Inferior Vena ◽  
Primary Tumour ◽  
Vena Cava ◽  
Biliary Tree ◽  
Budd Chiari Syndrome ◽  
Radiological Findings ◽  
Chiari Syndrome ◽  
The Right

Intrahepatic cholangiocarcinoma, an increasingly recognized primary tumour of the liver, is associated with a very poor prognosis. A patient with this tumour who presented with Budd-Chiari syndrome (the first to the authors' knowledge in Western literature and only the third patient overall) secondary to extensive thrombosis in his inferior vena cava extending from the right atrium down to his iliac vessels is described. Neither curative nor palliative intervention was deemed to be an option in this patient, who deteriorated rapidly while on anti-coagulants. Postmortem examination confirmed the radiological findings, and histological analysis revealed characteristic appearances of this tumour within the biliary tree and invasion into the inferior vena cava. Furthermore, biliary dysplasia, which can be a precursor to this cancer, was also noted within some of the bile ducts.

Stent Placement for Idiopathic Obstruction of the Inferior Vena Cava

1996 ◽  
Vol 4 (3) ◽  
pp. 142-145
Author(s):  
Rajiv Agarwal ◽  
Upendra Kaul ◽  
Pradeep Jain ◽  
Sanjeev Sharma ◽  
Sanjiv Sharma ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Balloon Angioplasty ◽  
Inferior Vena ◽  
Vena Cava ◽  
Total Occlusion ◽  
Inferior Vena Cava Obstruction ◽  
Mean Diameter ◽  
Chiari Syndrome ◽  
The Mean ◽  
The Right

Ten patients (mean age 36.6 ± 8 years; 5 male) with idiopathic inferior vena cava obstruction underwent balloon angioplasty, followed by placement of a self-expanding stent. Six had total occlusion, 5 had restenosis (including 2 with total occlusion), and I had a suboptimal result after initial dilatation. The mean diameter of the inferior vena cava increased from 1.5 ± 2.1 mm to 14.4 ± 2.7 mm, and the pressure gradient between the vena cava and the right atrium decreased from 15.2 ± 5.0 mm Hg to 1.1 ± 1.5 mm Hg. Follow-up venography after 74 ± 35 days in 6 patients, revealed ho restenosis, with further enlargement of the mean diameter by 5.2 ± 3.1 mm (44 ± 35%) and abolition of pressure gradients. One patient died 6 months after the procedure from acute Budd-Chiari syndrome. Autopsy revealed a widely patent stent with hepatic vein thrombus. Stent implantation is useful in the management of inferior vena cava obstruction with prior restenosis, total occlusion, or suboptimal results of balloon angioplasty.

Solitary fibrous renal tumor with thrombus extension into the inferior vena cava and right atrium

2021 ◽  
pp. 021849232199739
Author(s):  
Farouk Almohammad ◽  
Mohammad M Bakour
Keyword(s):  
Cardiac Surgery ◽  
Inferior Vena Cava ◽  
Solitary Fibrous Tumor ◽  
Right Atrium ◽  
Inferior Vena ◽  
Renal Tumor ◽  
Circulatory Arrest ◽  
Vena Cava ◽  
Deep Hypothermic Circulatory Arrest ◽  
Fibrous Tumor

A solitary fibrous tumor of the kidney with thrombus extended into the inferior vena cava and right atrium is very rare. The current surgical approach is to combine intra-abdominal and cardiac surgery with cardiopulmonary bypass. We describe a rare case of renal solitary fibrous tumor extended to the inferior vena cava and right atrium, treated with urgent cardiac surgery using deep hypothermic circulatory arrest one month after an inappropriate right nephrectomy because of the development of cavo-atrial obstruction symptoms.

scholarly journals A case report of an interrupted inferior vena cava and azygos continuation: implications for preoperative screening in minimally invasive cardiac surgery

2021 ◽  
Author(s):  
Wiebe G Knol ◽  
Frans B Oei ◽  
Ricardo P J Budde ◽  
Maarten ter Horst
Keyword(s):  
Cardiac Surgery ◽  
Inferior Vena Cava ◽  
Minimally Invasive ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Vena Cava ◽  
Minimally Invasive Cardiac Surgery ◽  
Azygos Continuation ◽  
Venous Cannula ◽  
The Right

Abstract Background Femoral cannulation is commonly used in minimally invasive cardiac surgery to establish extracorporeal circulation. We present a case with a finding that should be evaluated when screening candidates for minimally invasive cardiac surgery. Case presentation A 57-year-old male patient was scheduled for minimally invasive repair of the mitral and tricuspid valve and a MAZE-procedure. During surgery there was difficulty advancing the venous cannula inserted in the right femoral vein. On transesophageal echocardiography a guidewire advanced from the femoral vein was observed entering the right atrium from the superior vena cava. Despite inserting a second venous cannula in the jugular vein, venous drainage was insufficient for minimal invasive surgery. The approach was converted to a median sternotomy with bicaval cannulation. Re-examination of the preoperative computed tomography scan showed an interrupted inferior vena cava with azygos continuation. Discussion In patients with major venous malformations such as the interrupted inferior vena cava with azygos continuation a full sternotomy is the preferred approach. The venous system should be evaluated when screening candidates for minimally invasive mitral valve surgery with preoperative computed tomography. Additional cues to suspect interruption of the inferior vena cava are polysplenia and a broad superior mediastinal projection on the chest radiograph, mimicking a right paratracheal mass.

Budd-Chiari syndrome: An unusual complication of an internal jugular tunneled dialysis catheter

2021 ◽  
pp. 112972982110501
Author(s):  
Gabriel Stefan ◽  
Simona Stancu ◽  
Adrian Zugravu ◽  
Laura Predescu ◽  
Simona Cinca ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Jugular Vein ◽  
Vena Cava ◽  
Dialysis Catheter ◽  
Budd Chiari Syndrome ◽  
Chiari Syndrome ◽  
Catheter Malposition ◽  
The Right ◽  
Catheter Replacement

Budd-Chiari syndrome due to the tip of an internal jugular tunneled dialysis catheter malposition in inferior vena cava or hepatic vein is a rare complication. We aimed to present our experience and compare it with the previous reports to highlight the clinical features and the optimal management. A 57-year-old female with history of ANCAp vasculitis, treated by hemodialysis in the last 2 years on a right internal jugular vein tunneled catheter was admitted for pain in the right upper quadrant. A subacute Budd-Chiari syndrome due to catheter malposition was diagnosed. The catheter was removed, and a new tunneled hemodialysis line was inserted in the right internal jugular vein with the tip at the junction of right atrium with superior vena cava. Anticoagulation with apixaban 2.5 mg twice daily was started after catheter replacement and the patient was discharged. At 1 month follow-up the patient had no symptoms, and the ultrasound revealed the absence of the thrombus in the inferior vena cava. Imagining monitoring for malposition after insertion or in a clinical context suggestive for Budd-Chiari syndrome is essential for early diagnosis and treatment. In our case, anticoagulation with apixaban and prompt catheter replacement resulted in Budd-Chiari syndrome resolution.

scholarly journals Budd-Chiari syndrome due to giant hydatid cyst: a case report and brief literature review

2013 ◽  
Vol 7 (06) ◽  
pp. 489-493 ◽  
Author(s):  
Sami Akbulut ◽  
Mehmet Yilmaz ◽  
Aysegul Kahraman ◽  
Sezai Yilmaz
Keyword(s):  
Inferior Vena Cava ◽  
Hydatid Cyst ◽  
Hydatid Disease ◽  
Inferior Vena ◽  
Vena Cava ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Chiari Syndrome ◽  
Hepatic Venous Outflow ◽  
The Right

Budd-Chiari syndrome is an uncommon disorder characterized by the thrombotic or non-thrombotic obstruction of hepatic venous outflow anywhere along the venous course from the hepatic venules to the junction of the inferior vena cava and the right atrium. The etiology of Budd-Chiari syndrome is classified as primary, attributable to intrinsic intraluminal thrombosis or the development of venous webs; or secondary, caused by intraluminal invasion by a parasite or malignant tumor or extraluminal compression by an abscess, solid tumor, or cyst, such as a hydatid cyst. In this study, we present a case of a giant hydatid cyst manifesting Budd-Chiari syndrome symptoms and signs by compressing the inferior vena cava and hepatic veins. In brief, the case demonstrates that hydatid disease should be considered in the differential diagnosis of Budd-Chiari Syndrome in areas such as Turkey, where hydatid disease is endemic.

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