Transesophageal echocardiography diagnosis of tricuspid obstruction by a vena cava tumour

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.