Urgent resection of hepatocellular carcinoma with intracardiac extension under moderate hypothermic circulatory arrest
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ID: 319496
2026
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Abstract
Intracardiac extension of hepatocellular carcinoma (HCC) via the inferior vena cava (IVC) is uncommon and may result in fatal cardiac complications. We report a case of urgent cardiac surgery performed to prevent imminent cardiac deterioration and facilitate subsequent multidisciplinary treatment. A 64-year-old man with a history of right hepatectomy for stage III HCC and radiofrequency ablation for recurrent disease was admitted following a traffic accident. Echocardiography revealed a 4.6 × 3.6 cm right atrial mass continuous with the IVC. Although the patient had no overt cardiac symptoms, frequent episodes of non-sustained ventricular tachycardia and bilateral lower extremity oedema raised concern regarding impending cardiac complications. Urgent tumour resection was performed under moderate hypothermic circulatory arrest (lowest rectal temperature, 32 °C). Following cardiac and orthopedic surgery, the patient underwent transcatheter arterial chemoembolization and systemic therapy with durvalumab plus tremelimumab. At 1-year follow-up, no intracardiac recurrence was observed, pulmonary metastatic lesions had regressed, and the patient remained clinically stable. Urgent cardiac surgery may serve as a bridge to multidisciplinary treatment in selected patients with HCC and intracardiac extension.
| Reference Key |
openalex_W7167014664
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|---|---|
| Authors | Masaaki Kobayashi, Satoshi Kuroyanagi, Onichi Furuya, A Miki |
| Journal | Interdisciplinary CardioVascular and Thoracic Surgery |
| Year | 2026 |
| DOI |
10.1093/icvts/ivag192
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| URL | |
| Keywords | Keywords not found |
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