Retrograde aortic dissection encountered amidst nephrectomy for renal cell carcinoma with IVC thrombus – a case report

Background: Management of RCC with IVC thrombus can be surgically challenging, particularly when the tumour thrombus extends above the diaphragm. Cardiopulmonary bypass is often employed to aid surgical removal of the tumour in such cases. Case presentation: We detail an instance of 67-year-old Male patient suffering from RCC with IVC thrombus, with the tumour thrombus extending into the right atrium, who developed on-table retrograde type A aortic dissection amidst the surgical procedure, thereby precluding cardiopulmonary bypass. Transfixation of the renal arterial stump resulted in disappearance of the dissection flap. Conclusions: Operating surgeons should be mindful of the potential for retrograde aortic dissection during Radical Nephrectomy and its implications intraoperatively.