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Cytoreductive Surgery for Right Ventricular Sarcoma

Friday, December 18, 2020

Yan TD, Misfeld M. Cytoreductive Surgery for Right Ventricular Sarcoma. December 2020. doi:10.25373/ctsnet.13377116

The third of twelve videos in a CTSNet series on Thoracic Surgical Oncology - Technical Approaches by Professor Tristan D. Yan is presented here. To see the complete list of videos in the Thoracic Surgical Oncology video series, click here.

This 70-year-old man initially presented with dyspnea and presyncope. CTPA revealed a large obstructive mass within the right ventricle and main pulmonary artery, extending into both left and right pulmonary arteries. Transthoracic echocardiogram demonstrated severe pulmonary hypertension. Histopathology from samples taken at clot retrieval revealed the mass to be an intimal sarcoma. This presentation was further complicated by heparin-induced thrombocytopenia and thrombosis syndrome (HITTS). This video demonstrates the surgical approach and the anesthetic considerations in this patient, who underwent cytoreductive surgery for an extensive right ventricular sarcoma, bilateral pulmonary thromboendarterectomy, pulmonary valve replacement, pulmonary trunk reconstruction, and mitral valve replacement at the Royal Prince Alfred Hospital. The patient had an uneventful recovery.


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