Martinelli Susan M, Lobonc Andrew, Wallen Eric M, Stansfield William E, Selph J Patrick, Calvo Benjamin, Kumar Priya A
1 University of North Carolina, Chapel Hill, NC, USA.
2 University of Toronto, Toronto, ON, Canada.
Semin Cardiothorac Vasc Anesth. 2017 Mar;21(1):95-98. doi: 10.1177/1089253215616498. Epub 2016 Aug 1.
Although nephrectomy for renal cell carcinoma with inferior vena cava invasion is a common procedure, it is rare to have level IV invasion necessitating cardiopulmonary bypass (CPB). Furthermore, it is exceptionally rare to perform cardiac surgery concomitantly with this resection. We report a case in which an aortic valve replacement was done in the same surgical setting as a level IV thrombectomy. We have demonstrated that although it can be difficult to manage the coagulopathy post-CPB, this can be successfully accomplished with adequate prior preparation and a coordinated team effort.
虽然对伴有下腔静脉侵犯的肾细胞癌进行肾切除术是一种常见的手术，但出现需要体外循环（CPB）的IV级侵犯情况却很少见。此外，在此类切除手术中同时进行心脏手术的情况极为罕见。我们报告了一例在与IV级血栓切除术相同的手术环境下进行主动脉瓣置换的病例。我们已经证明，尽管体外循环后凝血功能障碍可能难以处理，但通过充分的术前准备和团队协作可以成功解决。
