title: Cavoatrial thrombectomy without the use of cardiopulmonary bypass for abdominal tumors. Our experience and state of the art.
abstract: BACKGROUND
  Surgical resection of a tumor with thrombus formation extending from the inferior vena cava (IVC) to the right atrium can be performed without the use of a cardiopulmonary bypass. However, this technique is not widely known or used by general surgeons. Our aim was to present our experience in a general surgical unit setting and to present a literature review.
  
  
  METHODS
  Retrospective analysis of 3 cases with successful cavoatrial thrombectomy without the use of cardiopulmonary bypass by a transabdominal, transdiaphragmatic, and transpericardic approach. We also performed a review of the English literature of this procedure.
  
  
  RESULTS
  Three cases are presented: right-sided hepatocellular carcinoma, a right renal carcinoma, and a recurrent hepatic hydatid cyst all which required surgery. An approach from the right atrium to the IVC was used, and then, after cavoatrial occlusion, a cavotomy was performed to carry out the thrombectomy. In all cases, a transesophageal echocardiography was performed during surgery. We only found 6 other similar cases that were performed successfully in current medical literature.
  
  
  CONCLUSIONS
  Our own experiences and cases identified through a literature review demonstrate that a thrombectomy for IVC thrombus in the setting of abdominal pathology can be performed successfully in selected cases without the support of cardiopulmonary bypass.
authors.affiliation: General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Madrid, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Vicente
authors.affiliation: General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Madrid, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Quijano
authors.affiliation: General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Madrid, Spain. Electronic address: ielpo.b@gmail.com.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Ielpo
authors.affiliation: General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Madrid, Spain.
authors.forename: Giuseppe Massimiliano
authors.initials: GM
authors.lastname: De Luca
authors.affiliation: General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Prestera
authors.affiliation: General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Madrid, Spain.
authors.forename: Hipolito
authors.initials: H
authors.lastname: Duran
authors.affiliation: General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Madrid, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Diaz
authors.affiliation: General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Madrid, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Fabra
authors.affiliation: General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Madrid, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Olivares
authors.affiliation: General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Madrid, Spain.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Caruso
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D005260:Female; D006325:Heart Atria / Q000601:surgery*; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017131:Thrombectomy / Q000379:methods*; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000601:surgery