CARDIOPULMONARY BYPASS AND CELL-SAVER TECHNIQUE IN COMBINED ONCOLOGICAND CARDIOVASCULAR-SURGERY

The purpose of this study was to work out an adequate operative techni que for patients with malignant tumors who also need open heart surger y or procedures on major blood vessels. We had 8 such patients. In 6 o f them, a tumor (3 cases hypernephroid cancer and 3 cases retroperiton eal sarcoma) had grown through the inferior vena cava (IVC) up to the right atrium. Two patients had lung cancer together with severe corona ry artery disease. All of these patients were operated on using a hear t-lung machine (HLM) and cell saver (CS). In 6 patients the intravascu lar portion of the tumor was extracted as much as possible through a r ight atrium approach (in 3 cases a nephrectomy was performed). Two pat ients had a one-stage coronary artery bypass graft (CABG) and a lobect omy. All of the patients had uneventful postoperative periods and were alive when checked on 1 year after the procedures. During cytological investigation after each operation, tumor cells were found only on th e internal surface of the HLM arterial filters with 20 mu m holes. We suggest that special cardiovascular devices such as the HLM and CS mig ht be used in borderline situations in oncology without increasing the risk of hematogenous tumor dissemination.