| A Case of Successful Treatment
of Intraoperative Pulmonary Tumor Embolism Using Pulmonary Angioscopy
under Cardiopulmonary Bypass |
(Department of Thoracic Surgery, Mie University,
Tsu, Japan)
| Tomoaki Suzuki |
Kuniyosi Tanaka |
Hidehito Kawai |
| Fumiaki Watanabe |
Chiaki Kondo |
Koji Onoda |
| Motoshi Takao |
Takatugu Shimono |
Hideto Sinpo |
| Isao Yada |
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The case involved a 73-year-old
woman who underwent surgical resection for right renal cell carcinoma
extending to the inferior vena cava. During surgery the tumor
thrombus disappeared from the inferior vena cava. We performed
transesophageal echocardiography and detected the tumor thrombus
in the right ventricle. Therefore, we immediately tried to remove
the thrombus using cardiopulmonary bypass. However, we could
not find the tumor thrombus in the right ventricle or in the
main pulmonary artery. We used angioscopy of the pulmonary artery
and detected the tumor thrombus at the orifice of the inferior
pulmonary artery. The tumor thrombus was removed under direct
visualization. In the event of an intraoperative pulmonary embolism,
simple and safe techniques for exact and rapid diagnosis are
needed. Intraoperative angioscopy allows direct visualization
of the pulmonary arterial branches and appears to be very useful
for detection of tumor thrombi even in emergency cases.
Jpn. J. Cardiovasc. Surg. 30: 274-276 (2001) |
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