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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 1998 Ottobre;39(5):641-7

CARDIAC PAPERS 

 ORIGINAL ARTICLES

Intra­op­er­a­tive man­age­ment for ­removal of ­tumor ­thrombus in the infe­rior ­vena ­cava or the ­right ­atrium ­with mul­ti­plane tran­se­soph­a­geal ech­o­car­di­og­raphy

Koide Y., Mizoguchi T., Ishii K., Okunura F.

From the Depart­ment of Anes­the­sio­logy, Yoko­hama ­City Uni­ver­sity ­School of Med­i­cine, Yoko­hama, ­Japan

Back­ground. To inves­ti­gate the ­role and ­impact of mul­ti­plane tran­se­soph­a­geal ech­o­car­di­og­raphy ­during throm­bec­tomy in the infe­rior ­vena ­cava or the ­right ­atrium.
Experi­mental ­design. Ret­ro­spec­tive.
Set­ting. A uni­ver­sity hos­pital.
Par­tic­i­pants. ­Four ­patients who under­went ­removal of ­tumor ­thrombus in the infe­rior ­vena ­cava (IVC) or the ­right ­atrium.
Inter­ven­tions. The med­ical ­records of 4 ­patients and vid­eo­tapes of ­these intra­op­er­a­tive tran­se­soph­a­geal echo-­car­di­og­raphy exam­ina­tions ­were ­reviewed.
­Results. ­Before throm­bec­tomy, mul­ti­plane tran­se­soph­a­geal ech­o­car­di­og­raphy (­MTEE) pro­vided excel­lent IVC ­long ­axis ­view, ­which ­offered pre­cise rec­og­ni­tion of the ­cephalic ­extent of ­tumor, ­extent of ­caval occlu­sion, char­ac­ter­iza­tion of the ­tumor ­head. ­During sur­gery, ­MTEE ­could pro­vide con­tin­uous mon­i­toring of car­diac func­tion, car­diac ­volume, and pul­mo­nary embo­lism. More­over, ­MTEE ­could pro­vide the ­useful ­images of a can­nula or the ­caval occlu­sion bal­loon cath­eter, ­which facil­i­tated ­removal of neo­plasm ­extending ­into the IVC.
Con­clu­sions. We pre­sented ­four sur­gical ­cases, in ­which the ­removal of the ­tumor ­extended ­into the infe­rior ­vena ­cava or the ­right ­atrium ­using ­MTEE. ­MTEE ­could pro­vide val­u­able infor­ma­tion ­such as excel­lent ­images of the ­tumor, car­diac func­tion, the posi­tion of a can­nula or the ­caval occlu­sion bal­loon cath­eter. ­These find­ings ­could ­improve the anes­thetic man­age­ment of the ­patients, as ­well as the sur­gical ­approach and tech­nical maneu­vers, and facil­i­tate ­removal of neo­plasm ­into the IVC.

lingua: Inglese


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