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Right Atrium Tumor Extension Through the Inferior Vena Cava. Considerations About Nine Cases Operated Under Cardiopulmonary Bypass.

Authors
  • Chaud, Fernando1
  • Tucci, Silvio Junior2
  • Bassetto, Solange2
  • Reis, Rodolfo Borges Dos2
  • Rodrigues, Alfredo José2
  • Vicente, Walter Vilella de Andrade2
  • Evora, Paulo Roberto Barbosa2
  • 1 Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto Department of Pathology Ribeirão Preto SP Brazil Department of Pathology, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil. , (Brazil)
  • 2 Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto Department of Surgery and Anatomy Ribeirão Preto SP Brazil Department of Surgery and Anatomy, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil. , (Brazil)
Type
Published Article
Journal
Brazilian journal of cardiovascular surgery
Publication Date
Jan 01, 2020
Volume
34
Issue
6
Pages
723–728
Identifiers
DOI: 10.21470/1678-9741-2019-0053
PMID: 31545579
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Adrenocortical and renal cell carcinomas rarely invade the right atrium (RA). These neoplasms need surgical treatment, are very aggressive and have poor prognostic and surgical outcomes. We present a retrospective cohort of nine cases of RA invasion through the inferior vena cava (four adrenocortical carcinomas and five renal cell carcinomas). Over 13 years (2002-2014), nine patients were operated in collaboration with the team of urologists. Surgery was possible in all patients with different degrees of technical difficulty. All patients were operated considering the imaging examinations with the aid of CPB. In all reported cases (renal or suprarenal), the decision to use CPB with deep hypothermic circulatory arrest (DHCA) on surgical strategy was decided by the team of urological and cardiac surgeons. Data retrospectively collected from patients of public hospitals reaffirm: 1) Low incidence with small published series; 2) The selected cases did not represent the whole historical casuistry of the hospital, since they were selected after the adoption of electronic documentation; 3) Demographic data and references reported in the literature were presented as tables to avoid wordiness; 4) The series highlights the propensity to invade the venous system; 5) Possible surgical treatment with the aid of CPB in collaboration with the urology team; 6) CPB with DHCA is a safe and reliable option; 7) Poor prognosis with disappointing late results, even considering the adverse effects of CPB on cancer prognosis are expected but not confirmed.

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