Inguna Krustiņa

Pauls Stradiņš Clinical University Hospital

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

Pēteris Stradiņš

Pauls Stradiņš Clinical University Hospital

Roberts Rumba

Pauls Stradiņš Clinical University Hospital

Kristiāns Meidrops

Pauls Stradiņš Clinical University Hospital

Laura Veinberga

Riga Stradiņš University

Armands Sīviņš

University of Latvia

Karina Drizlionoka

Pauls Stradiņš Clinical University Hospital

Deniss Anufrijevs

Pauls Stradiņš Clinical University Hospital

J. Bērziņš

University of Latvia

Maija Radziņa

Riga Stradiņš University

Artūrs Ozoliņš

Riga Stradiņš University

Cooperative Institutions

Pauls Stradiņš Clinical University Hospital

Riga Stradiņš University

University of Latvia

Riga East University Hospital

Riga Technical University

Latvia University of Life Sciences and Technologies

Unidad de Cirugía Artroscópica

Foundation for Ichthyosis and Related Skin Types

State Education Development Agency

Latvian Maritime Academy

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Supplementary Material for: Surgical Treatment of Hepatocellular Carcinoma with a Tumor Thrombus Invading the Right Atrium: A Case Report

Figshare (2023)

Laura Veinberga Kristiāns Meidrops Roberts Rumba Mārcis Gediņš Deniss Anufrijevs

Up to 3% of all HCC present with a tumor thrombus (TT) in the inferior vena cava (IVC) and right atrium (RA). Extensive growth of HCC into the IVC and the RA is associated with a particularly poor prognosis. This clinical condition is related to a high risk of sudden death due to pulmonary embolism or acute heart failure. Therefore, a technically challenging treatment undergoing hepatectomy and cavo-atrial thrombectomy is necessary. We report a 61-year-old man presenting with right subcostal pain, progressive weakness and periodic shortness of breath for 3 months. He was diagnosed with advanced HCC with a tumor thrombus (TT) extending from the right hepatic vein into the inferior vena cava (IVC) and right atrium (RA). A multidisciplinary meeting with cardiovascular and hepatobiliary surgeons, oncologists, cardiologists, anesthesiologists and radiologists was held to determine the best treatment approach. Initially, the patient underwent right hemihepatectomy. As follows, the cardiovascular stage using cardiopulmonary bypass was successfully performed, removing the TT from the RA and ICV. In the early postoperative period the patient remained stable and was discharged on the 8th postoperative day. A morphological examination revealed Grade 2/3 HCC, a clear cell variant with the microvascular and macrovascular invasion. Immunohistochemical staining was positive for HEP-1, CD10, whereas negative for S100. The morphological and immunohistochemical results corresponded to HCC. The treatment of such patients requires the cooperation of various specialties. Although, the approach of the surgery is extremely complex including specific technical support, as well as high perioperative risks, the result offers favorable clinical outcomes.

Atrium (architecture)

10.6084/m9.figshare.22348153

Cite

Citations (0)

Surgical Treatment of Hepatocellular Carcinoma with a Tumor Thrombus Invading the Right Atrium: A Case Report

Case Reports in Oncology (2023)

Laura Veinberga Kristiāns Meidrops Roberts Rumba Mārcis Gediņš Deniss Anufrijevs

Up to 3% of all hepatocellular carcinomas (HCCs) present with a tumor thrombus (TT) in the inferior vena cava (IVC) and right atrium (RA). Extensive growth of HCC into the IVC and the RA is associated with a particularly poor prognosis. This clinical condition is related to a high risk of sudden death due to pulmonary embolism or acute heart failure. Therefore, a technically challenging treatment undergoing hepatectomy and cavo-atrial thrombectomy is necessary. We report a 61-year-old man presenting with right subcostal pain, progressive weakness, and periodic shortness of breath for 3 months. He was diagnosed with advanced HCC with a TT extending from the right hepatic vein into the IVC and RA. A multidisciplinary meeting with cardiovascular and hepatobiliary surgeons, oncologists, cardiologists, anesthesiologists, and radiologists was held to determine the best treatment approach. Initially, the patient underwent right hemihepatectomy. As follows, the cardiovascular stage using cardiopulmonary bypass was successfully performed, removing the TT from the RA and ICV. In the early postoperative period, the patient remained stable and was discharged on the 8th postoperative day. A morphological examination revealed grade 2/3 HCC, a clear cell variant with microvascular and macrovascular invasion. Immunohistochemical staining was positive for HEP-1, CD10, whereas negative for S100. The morphological and immunohistochemical results corresponded to HCC. The treatment of such patients requires the cooperation of various specialties. Although the approach of the surgery is extremely complex including specific technical support, as well as high perioperative risks, the result offers favorable clinical outcomes.

10.1159/000529831

Cite

Citations (1)

Assessment of Tissue Perfusion During Cardiopulmonary Bypass

Proceedings of the Latvian Academy of Sciences Section B Natural Exact and Applied Sciences (2009)

N. Porite Eva Strīķe Mihails Bekers-Ančipolovskis Larisa Semčenko Inguna Krustiņa

Assessment of Tissue Perfusion During Cardiopulmonary Bypass Cardiopulmonary bypass (CPB) remains essential for all valvular operations and the vast majority of coronary bypass surgeries. Inadequate CPB results in tissue underperfusion, activation of anaerobic metabolism and increased lactate production. The goal of the study was to determine the factors influencing oxygen delivery to and consumption in tissue. Fifty-six patients (41 male and 14 female patients of 27 to 84 years of age) scheduled to undergo cardiac surgery with CPB were enrolled in this prospective study. No operation-based selection was applied. The following data have been collected and analysed: demographics, preoperative cardiovascular profile. Arterial and venous blood gas tests, including blood glucose and lactate concentrations were obtained. We have assessed DO 2 (mL/min/m 2 ) and VO 2 (mL/min/m 2 ), venous oxygen content (CvO 2 ) (mL/dL), arterial oxygen content (CaO 2 ) (mL/dL) calculated according to standard equations based on haemoglobin concentration and saturation in arterial blood, cardiac output or pump flow. The main factors of organ dysoxia during CPB are the haemodilution degree and low peripheral oxygen delivery (DO 2 ). Our study confirmed that hematocrit on pump and systemic flow rate determine the amount of oxygen delivery to the body, i.e. DO 2 decrease is correlated with decrease of both hematocrit (Ht) and pump flow.

Venous blood

Arterial blood

Oxygenator

10.2478/v10046-009-0047-0

Cite

Citations (0)