• Bruno Chiappini, Carlo Savini, Giuseppe Marinelli, Sofia Martin Suarez, Marco Di Eusanio, Vinicio Fiorani, and Angelo Pierangeli.
• Department of Cardiovascular Surgery, Policlinico S. Orsola-Malpighi, University of Bologna, via Massarenti, 9-40138 Bologna, Italy. bruno_chiappini@hotmail.com
• J. Thorac. Cardiovasc. Surg. 2002 Oct 1;124(4):684-8.

BackgroundIn recent years, heart surgery has been used more frequently to treat diseases that are not primarily of cardiac origin. This is the case for intracardiac extension of infradiaphragmatic tumors, such as renal cell carcinoma, Wilms tumor, uterine tumors, and adrenal tumors, which require radical surgery associated with cavoatrial thrombectomy.MethodsFrom April 1987 to April 2001, 13 patients with an infradiaphragmatic tumor with thrombosis of the vena cava, the right atrium, or both underwent surgical resection with cardiopulmonary bypass, arrested circulation, and profound hypothermia.ResultsThe in-hospital mortality was 0%. The postoperative complications were respiratory failure (1 patient) and a redo operation for bleeding (1 patient). After a mean follow-up time of 33.9 months, 8 (61.5%) patients were alive.ConclusionsThe use of extracorporeal circulation and deep circulatory arrest provide an optimal technique for removing the tumor thrombus in a bloodless field, even in the presence of metastatic disease, and has good early and long-term results.

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