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Transesophageal echocardiograhy diagnosis of tricuspid obstruction by a vena cava tumour

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Abstract

Purpose: To present the anesthetic management for excision of a primary tumour of the inferior vena cava.

Clinical features: Resection of a primary tumour of the inferior vena cava without extension to the right atrium was scheduled without extra-corporeal circulation (ECC). The operation consisted of tumour excision with transtumoral clamping. During the immediate postoperative period, tricuspid obstruction was suspected when a “cannon a wave” was recorded from the right atrial pressure curve. Transesophageal echocardiography confirmed the diagnosis of tumour obstruction of the tricuspid valve.

Conclusion: Tricuspid obstruction due to postoperative mobilization of a primary tumour of the inferior vena cava was diagnosed by transesophageal echocardiography. Perioperative management particularities of the primary tumour of the vena cava are discussed.

Résumé

Objectif: Présentation de la prise en charge périopératoire d’une intervention de résection d’une tumeur primitive de la veine cave inférieure, stratégie non trouvée dans la littérature.

Observation clinique: La résection d’une tumeur de la veine cave inférieure, non étendue à l’oreillette droite, a été plantifiée sans circulation extra-corporelle. L’intervention a consisté en la tumorectomie avec ligature transtumorale de la veine cave. Au cours de la période postopératoire immédiate, une obstruction tricuspidienne a été suspectée devant l’apparition d’une onde a géante sur la tracé de pression veineuse centrale. Le diagnostic d’obstruction tricuspidienne tumorale a été confirmé par une échocardiographie transoesophagienne.

Conclusion: L’obstruction tricuspidienne secondaire à la mobilisation postopératoire d’une tumeur primitive de la veine cave inférieure a été diagnostiquée par échocardiographie transoesophagienne. Les particularités de cette chirurgie et de l’anesthésie sont exposées.

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Correspondence to Y. Blanloeil MD.

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Blanloeil, Y., Le Roux, C., Rigal, J.C. et al. Transesophageal echocardiograhy diagnosis of tricuspid obstruction by a vena cava tumour. Can J Anesth 48, 401–404 (2001). https://doi.org/10.1007/BF03014972

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Keywords

  • Inferior Vena
  • Tricuspid Valve
  • Leiomyosarcoma
  • Transthoracic Echocardiography
  • Transesophageal Echocardiography