title: [Intraoperative transesophageal echocardiography to guide removal of a hypernephroma with vena cava and right atrial extension].
abstract: We describe the case of a 70-year-old man who underwent resection of a right hypernephroma with vena caval and right atrial extension with continuous monitoring by transesophageal echocardiography. The monitoring technique brought important advantages, providing images that facilitated anatomical and functional evaluation of cardiac structures without obstructing the surgical field. Images of the heart and great vessels obtained in real time allowed the surgeon to make operative decisions based on accurate assessment of the cephalad extension of the tumor to the right chambers. Transesophageal echocardiography also allowed the anesthesiologist to monitor hemodynamic status throughout surgery and watch for tumoral emboli. The imaging technique proved to be highly useful for both anesthetic and surgical management of the patient.
authors.affiliation: Departamento de Anestesiología e Intermedio Quirúrgico, Hospital Clinico Dr. Rail Yazigi Fuerza Aérea de Chile, Las Condes, Santiago de Chile. Carol218@vtr.net
authors.forename: M C
authors.initials: MC
authors.lastname: Cabrera
authors.forename: C
authors.initials: C
authors.lastname: Murillo
authors.forename: V
authors.initials: V
authors.lastname: Díaz de Valdés
authors.forename: J
authors.initials: J
authors.lastname: Farías
authors.forename: P
authors.initials: P
authors.lastname: Bernier
authors.forename: E U
authors.initials: EU
authors.lastname: Luly de La Fuente
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D003937:Diagnosis, Differential; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007431:Intraoperative Complications / Q000209:etiology; D007680:Kidney Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D016343:Monitoring, Intraoperative; D009361:Neoplasm Invasiveness; D009360:Neoplastic Cells, Circulating; D009392:Nephrectomy; D018084:Ultrasonography, Interventional; D019043:Vascular Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D020246:Venous Thrombosis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology