Purpose: To present the anesthetic management for excision of a primary tum
our 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 transtu
moral clamping. During the immediate postoperative period, tricuspid obstru
ction was suspected when a "cannon a wave" was recorded from the right atri
al pressure curve. Transesophageal echocardiography confirmed the diagnosis
of tumour obstruction of the tricuspid valve.
Conclusion: Tricuspid obstruction due to postoperative mobilization of a pr
imary tumour of the inferior vena cava was diagnosed by transesophageal ech
ocardiography. Perioperative management particularities of the primary tumo
ur of the vena cava are discussed.