Surgical technique of removal of inferior vena cava leiomyosarcoma extending into the right atrium without deep hypothermic circulatory arrest

Mohammed Hassan, Gaetano Ciancio, Samir P. Shirodkar, Miguel B. Del Mazo, Michael Barron, Tomas Salerno, Alan Livingstone

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Leiomyosarcoma of the inferior vena cava is a rare tumor with potential for significant morbidity and mortality. Surgical extirpiration remains the optimal treatment choice. A case of caval leiomyosarcoma with right atrial extension is presented with management techniques and literature review. Methods: A 54 year old woman with constitutional symptoms was found to have advanced caval leiomyosarcoma with atrial extension. Surgical excision was performed without deep hypothermic circulatory arrest (DHCA), including right nephrectomy, adrenalectomy, and en-bloc resection of the vena cava along with Gore-Tex interposition graft. Results: There were no operative complications. The patient was extubated on postoperative day one. Renal function remained normal. Final pathology was high grade leiomyosarcoma. Margins were negative. The patient is well at latest follow up. Conclusion: Resection of extensive caval leiomyosarcoma allows the best chance of cure and is possible without DHCA. Perioperative planning and coordination and adherence to oncologic techniques is critical.

Original languageEnglish
Pages (from-to)277-281
Number of pages5
JournalJournal of Cardiac Surgery
Volume25
Issue number3
DOIs
StatePublished - May 1 2010

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Deep Hypothermia Induced Circulatory Arrest
Leiomyosarcoma
Inferior Vena Cava
Heart Atria
Venae Cavae
Adrenalectomy
Nephrectomy
Pathology
Morbidity
Transplants
Kidney
Mortality
Neoplasms

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Surgical technique of removal of inferior vena cava leiomyosarcoma extending into the right atrium without deep hypothermic circulatory arrest. / Hassan, Mohammed; Ciancio, Gaetano; Shirodkar, Samir P.; Del Mazo, Miguel B.; Barron, Michael; Salerno, Tomas; Livingstone, Alan.

In: Journal of Cardiac Surgery, Vol. 25, No. 3, 01.05.2010, p. 277-281.

Research output: Contribution to journalArticle

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AU - Barron, Michael

AU - Salerno, Tomas

AU - Livingstone, Alan

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AB - Background: Leiomyosarcoma of the inferior vena cava is a rare tumor with potential for significant morbidity and mortality. Surgical extirpiration remains the optimal treatment choice. A case of caval leiomyosarcoma with right atrial extension is presented with management techniques and literature review. Methods: A 54 year old woman with constitutional symptoms was found to have advanced caval leiomyosarcoma with atrial extension. Surgical excision was performed without deep hypothermic circulatory arrest (DHCA), including right nephrectomy, adrenalectomy, and en-bloc resection of the vena cava along with Gore-Tex interposition graft. Results: There were no operative complications. The patient was extubated on postoperative day one. Renal function remained normal. Final pathology was high grade leiomyosarcoma. Margins were negative. The patient is well at latest follow up. Conclusion: Resection of extensive caval leiomyosarcoma allows the best chance of cure and is possible without DHCA. Perioperative planning and coordination and adherence to oncologic techniques is critical.

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