Abstract

Renal cell carcinoma occasionally invades the inferior vena cava and rarely extends to the right atrium and occurred massive pulmonary embolism. A healthy 54-year-old man presented to the emergency room with anterior chest pain, dyspnea and hypotension from which he had been suffering for several hours. We diagnosed him as left renal cell carcinoma with acute both pulmonary arteries embolism. The patient underwent a complex surgical procedure in which left radical nephrectomy, inferior vena cava thrombectomy and both pulmonary arteries thromboembolectomy under deep hypothermic circulatory arrest. Total circulatory arrest time was 44 minutes. We should use many inotropic agents for weaning of cardiopulmonary bypass. The patient had many postoperative complications including of acute renal failure, respiratory distress and sepsis. He died from septic shock and multi organ failure at 36th postoperative day.

• Keywords: Renal cell carcinoma, Acute pulmonary embolism, Deep hypothermic circulatory arrest