Right Radical Nephrectomy with Type-IV IVC Tumor Thrombectomy Using Venovenous Bypass Instead of Cardiopulmonary Bypass—A Case Report

Abstract

A renal mass with level Level IV IVC thrombus is usually managed with radical nephrectomy and IVC thrombectomy. This procedure requires the assistance of a cardiac surgeon and is usually done under complete cardiopulmonary bypass. However, the use of cardiopulmonary bypass is associated with reduced cardiac venous return and can consequently decrease cardiac output, adversely affecting haemo-dynamic stability and systemic arterial perfusion. This can lead to relative ischemia of the abdominal viscera, lower limbs and kidneys. We report a case where radical nephrectomy with IVC thrombectomy was done under venovenous bypass, thus avoiding the complications associated with the cardiopulmonary bypass.