Table 2 Surgical steps as per level of IVC involvement by tumor.
Surgical steps - IVC involvement |
|---|
↓ |
Level I-II (60% of the cases) No cardiothoracic involvement/Cardiothoracic "back up" only |
↓ |
Level III & IV disease mandates Cardiothoracic involvement |
↓      ↓ |
LEVEL III (12-15% of the cases) |
LEVEL IV (25% of the cases) |
CPB, Pringle manoeuvre and if necessary |
Always use of CPB and brief period of cross clamp of sub-diaphragmatic aorta TCA |
If suboptimal thrombectomy, then brief TCA |