title: Transoesophageal echocardiography reduces invasiveness of cavoatrial tumour thrombectomy.
abstract: The traditional approach to cavoatrial thrombus excision requires median sternotomy, cardiopulmonary bypass with or without hypothermia and circulatory arrest and is associated with significant morbidity and mortality. We describe a transoesophageal echocardiography guided balloon catheter assisted technique for cavoatrial thrombectomy that avoids thoracotomy, extracorporeal circulation and circulatory arrest as an alternative to traditional methods. A 74-year-old man presented with a right solid renal mass confined to the kidney with thrombus extension through the right renal vein and the inferior vena cava into the right atrium. A right radical nephrectomy with cavoatrial thrombectomy under transoesophageal echocardiography guidance was successfully achieved using a balloon catheter-assisted technique with minimal intra-and postoperative morbidity. Cavoatrial tumour thrombectomy can be successfully performed without cardiopulmonary bypass, hypothermia and circulatory arrest.
authors.affiliation: Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Sobczyński
authors.affiliation: Department of Urology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Golabek
authors.affiliation: Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland ; Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Mazur
authors.affiliation: Department of Urology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Chłosta
keywords: cavoatrial thrombus; renal cancer; surgical management; thrombectomy