Atrioventricular Block Induced by Exercise Is Not Always Infrahisian

147 Rev Esp Cardiol. 2005;58(10):1246-8 1247 ment by those who defend the two-stage procedures was not especially notable in our case. Circulatory arrest with deep hypothermia avoids subjecting the liver and kidneys to periods of warm ischemia. Other advantages of this technique are the physical benefits for the patient and economic benefits for the system, as the surgery is performed in a single operation. We are of the opinion that a multidisciplinary surgical approach is of fundamental importance for the proper management of this lesion. In view of the low incidence of embolism and the limited number of adhesions involved, some authors propose employing only laparotomy in the removal of tumors of this type.6 In our opinion, this approach should be avoided as it can pose a threat due to possible tumor emboli, lesions in vessels in which vascular control has not been achieved and the risk of an incomplete resection. A right atrial approach should be avoided for the same reasons. Deaths due to retroperitoneal exsanguination have been reported.