title: Transesophageal echocardiography-guided thrombectomy of intracardiac renal cell carcinoma without cardiopulmonary bypass.
abstract: Advanced renal cell carcinoma (RCC) resection has important anesthetic management implications, particularly when tumor extends, suprahepatic, into the right atrium. Use of transesophageal echocardiogram (TEE) is essential in identifying tumor extension and guiding resection. Latest surgical approach avoids venovenous and cardiopulmonary bypass yet requires special precautions and interventions on the anesthesiologist's part. We present a case of Level IV RCC resected without cardiopulmonary bypass and salvaged by TEE guidance and detection of residual intracardiac tumor.
authors.affiliation: Department of Anesthesiology, University of Miami/Jackson Health System, Miami, Florida, USA.
authors.forename: Fouad Ghazi
authors.initials: FG
authors.lastname: Souki
authors.affiliation: Department of Anesthesiology, University of Miami/Jackson Health System, Miami, Florida, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Demos
authors.affiliation: Department of Anesthesiology, University of Miami/Jackson Health System, Miami, Florida, USA.
authors.forename: Lilibeth
authors.initials: L
authors.lastname: Fermin
authors.affiliation: Department of Surgery, Division of Transplantation, Miami Transplant Institute, University of Miami/Jackson Health System, Miami, Florida, USA.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Ciancio
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000601:surgery; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*