A new technique for management of renal cell carcinoma involving the right atrium: hypothermia and cardiac arrest.

A 36-year-old man presented with massive edema below the axillae, pleural effusion and renal cell carcinoma with a tumor thrombus extending up the vena cava to the right atrium. A metastatic evaluation was negative otherwise. Hypothermia, cardiac arrest and temporary exsanguination in conjunction with cardiopulmonary bypass were used to create a bloodless field for excision of the renal cell carcinoma and its tumor thrombus. The patient has had total resolution of all symptoms and edema. Hypothermia and cardiac arrest facilitated greatly surgical excision and may be a useful adjunct in the excision of malignancies with massive involvement of the great vessels or heart.