title: Novel approach to recurrent cavoatrial renal cell carcinoma.
abstract: Renal cell carcinoma (RCC) with cavoatrial extension is a rare and complex problem. Complete resection is difficult but correlates with favorable patient outcomes. We present 2 cases of successful reoperative resections of recurrent RCC in patients with level III-IV cavoatrial involvement. We used a thoracoabdominal approach, peripheral cannulation, and hypothermic circulatory arrest. We advocate this novel approach as a successful means of avoiding a more difficult reoperation.
authors.affiliation: Division of Cardiac Surgery, Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Alejo
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: George
authors.forename: Claude A
authors.initials: CA
authors.lastname: Beaty
authors.forename: Mohamad E
authors.initials: ME
authors.lastname: Allaf
authors.forename: James H
authors.initials: JH
authors.lastname: Black
authors.forename: Ashish S
authors.initials: AS
authors.lastname: Shah
mesh_terms: D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D003131:Combined Modality Therapy; D017548:Echocardiography, Transesophageal / Q000379:methods; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced / Q000379:methods; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006338:Heart Neoplasms / Q000556:secondary / Q000601:surgery*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D007430:Intraoperative Care / Q000379:methods; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010690:Phlebography / Q000379:methods; D012086:Reoperation; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000556:secondary / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery