Anesthetic management for intraoperative acute pulmonary embolism during inferior vena cava tumor thrombus surgery: A case report

Figure 1 Abdominal magnetic resonance imaging for preoperative evaluation. A: The inferior vena cava (IVC) tumor thrombus was at intrahepatic level, which was graded as level II (extends into the IVC, > 2 cm above the renal vein but below the hepatic veins; indicated by yellow arrow); B: Left renal tumor with renal vein invasion (indicated by yellow arrow).

Figure 2 Intraoperative capnography when acute pulmonary embolism was suspected. Oscillating of the plateau phase (phase III, indicated by yellow arrow) of capnography was observed in each breath.

Figure 3 Intraoperative transesophageal echocardiography. Middle-esophageal bicaval view of transesophageal echocardiography showed tumor thrombus in inferior vena cava (indicated by yellow arrow).

Figure 4 Postoperative chest computer tomography pulmonary angiogram. Filling defects was observed in bilateral pulmonary arteries (indicated by yellow arrow).