[HSF] Renal cell ca

[A]

Thanks Michael good point I will remember that

Ahmed

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Michael
Firstenberg
Sent: Monday, June 04, 2007 3:58 AM
To: OpenHeart-L at lists.hsforum.com
Subject: Re: [HSF] Renal cell ca

The few of these that I have done, I have put the venous line in the IVC,
below the renal veins.  It is exposed very nicely by the urologists and it
is sitting right there - and avoids going into a groin.  It also reminds
them to be careful and keeps them focused since you are on-pump.


-michael


On 6/4/07, A <alsadd at ksu.edu.sa> wrote:
>
> Jay:
> Interesting approach as we have an aggressive group of urologists we may
> be
> called to one of these. My question where do you put venous line? Do you
> only use the SVC and go bypass on one venous canula? Please clarify
> Thanks
>
> Ahmed
>
>
>
>
> On 5/31/07, Jacob Lavee, MD <jaylavee at netvision.net.il> wrote:
> >
> > Ed,
> > I've done 6 such cases together with our urologists and they were all
> > successful. In all cases we've gone on pump following initial abdominal
> > preparation by the urologists and cooled the patients down to deep
> > hypothermia. Once total circulatory arrest is initiated we've worked in
> > parallel - me opening the RA and evacuating the tumor tissue from the
> RV,
> RA
> > and down the IVC as far as I could get from inside the RA, while they
> opened
> > the abdominal IVC and took out the rest of the tumor from below, until
> both
> > our fingers could meet each others from inside the IVC. The rest of the
> > operation is straight forward being completed by nephrectomy. In all
> these
> > cases the urologists blessed me for providing them a clean and bloodless
> > environment to clean the entire IVC and sometimes even into the iliacs.
> >
> > Jay Lavee
> >
> > From: Edward Bender
> > To: OpenHeart-L
> > Sent: Thursday, May 31, 2007 5:50 AM
> > Subject: [HSF] Renal cell ca
> >
> >
> > Here's tomorrow's interesting case.  60 year old insulin dependent
> > diabetic hypertensive smoking female with hematuria.  She has a right
> > renal cell carcinoma with tumor thrombus.  I had her cathed and she
> > has normal coronaries.  Below are the relatively suboptimal CT scans
> > and echo.  I've never had to go on bypass to resect one of these, but
> > this one may be different.  There is extensive thrombus extending
> > into the RV through the tricuspid valve.  There is retrograde
> > thrombus into the left renal vein and the distal IVC and iliac vein.
> > I plan on trying to pull this down from below, but will be ready to
> > go on bypass if needed.  Any words of wisdom?  Below are selected
> > pictures.
> >
> > Ed Bender, MD
> >
> >
> >
> >
> > __________ NOD32 2299 (20070530) Information __________
> >
> > This message was checked by NOD32 antivirus system.
> > http://www.eset.com
> >
> >
> >
> >
> >
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