Anesthesia management for surgical resection of inferior vena caval tumor thrombus extending into right cardiac cavities.

Abstract

Inferior vena caval (IVC) tumor thrombus, majorly originated from intravenous leiomyomatosis (IVL) and renal or hepatic carcinoma, can extend into right cardiac cavities. Complete tumor resection, supported by cardiopulmonary bypass (CPB), has been proved to be the most effective treatment but also to be dramatically challenging. Randomized clinical trials of the surgical treatment for IVC tumor with cardiac extension are very limited due to the disease rarity, whereas publications on IVC tumor surgery are predominately confined to case report. So far, no clinical research or review, focused on intraoperative anesthesia management for surgical resection of IVC tumor with cardiac extension, has been identified; even anesthesia-targeted case report can not be found. In this article, we briefly introduce the disease characteristic and related surgical procedure and offer some suggestions upon the anesthesia management based on our own clinical experiences.