Resection of Inferior Vena Cava Leiomyosarcoma: Transesophageal Echocardiography Salvaged from Wreckage

Intraoperative transesophageal echocardiography (TEE) examination has evolved in cardiac and major vascular surgeries. It is not only useful in guiding hemodynamic interventions but also useful in surgical decision-making. It is necessary for the detection of intracardiac mass. Primary leiomyosarcoma confined to inferior vena cava (IVC) and without cardiac extension entails en bloc excision which seldom requires intracardiac exploration unless embolization. The embolization of the tumor causes hemodynamic alteration and can be confirmed by perioperative TEE evaluation. We are reporting a case where TEE salvaged from the wreckage by converting an extracardiac vascular procedure to intracardiac exploration under cardiopulmonary bypass.