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As dissection proceeded cephalad to separate the tumor from the great vessels, bleeding was encountered from the IVC. Proximal vascular control was not obtainable because of the bulk of the tumor. Bleeding was controlled manually while the cardiothoracic surgeon scrubbed in. Cell savers were attached to the suctions.
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It was determined that the bleeding could not be definitively controlled because of limited exposure, so veno-atrial bypass was begun. The femoral vein was located.
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