title: Anaesthetic management of a patient with the intracardiac extension of Wilms' tumour.
abstract: Summary Wilms' tumour (nephroblastoma) is known to invade the inferior vena cava and extend to the intracardiac chambers. We describe the treatment and surgical removal of the intracardiac extension of a Wilms' tumour using cardiopulmonary bypass in a 4-year-old girl. Techniques to avoid paradoxical embolism in the presence of a patent foramen ovale and to deal with excessive hepatic venous blood flow using the Pringle manoevre (hepatic inflour occlusion) are described. Good communication between anaesthesiologists, surgeons and perfusionists was indispensable. The anaesthesiologist is an important member of the team during performance of a complicated procedure.
authors.affiliation: Department of Anaesthesiology, Nagano Children's Hospital, 3100 Toyoshina, Toyoshina, Minamiazumi-gun, Nagano, Japan. tohru_shiratori@yahoo.co.jp
authors.forename: Tohru
authors.initials: T
authors.lastname: Shiratori
authors.forename: Tatsurou
authors.initials: T
authors.lastname: Fujisawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Ichino
authors.forename: Yuusuke
authors.initials: Y
authors.lastname: Mitono
authors.forename: Mari
authors.initials: M
authors.lastname: Inokuti
authors.forename: Jun
authors.initials: J
authors.lastname: Ohata
mesh_terms: D000768:Anesthesia, General / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D002315:Cardiopulmonary Bypass; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005260:Female; D006338:Heart Neoplasms / Q000556:secondary* / Q000601:surgery; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006503:Hepatic Veins / Q000503:physiopathology; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008102:Liver Circulation / Q000502:physiology; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D009396:Wilms Tumor / Q000556:secondary* / Q000601:surgery
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous