[Extracorporeal circulation for removal of carcinoma of the lung invading the left atrium]

A 42-year-old man with one year history of cough and chest pain due to right upper lung cancer was scheduled for radical surgery. An echocardiogram and a lung scan showed a tumor mass in the left atrium, which was originating from carcinoma of the right upper lobe. Right pneumonectomy and atrial tumor extirpation were done successfully under the state of cardiac arrest using extracorporeal circulation with topical cooling by crushed ice in order not to spread the tumor cells into systemic circulation. He was extubated on the 1st postoperative day. But, thereafter he developed moderate dyspnea. On 7, 10 and 13th postoperative days he fell into the state of CO2 narcosis. Decreased capacity of the lung after the pneumonectomy and left phrenic nerve injury during the operation were considered factors causing the respiratory insufficiency. Patient was discharged 6 weeks later and continued to have consultations at the outpatient clinic.