For the first time in the Volga Federal District: BSMU Clinic performed a unique operation in cardiopulmonary bypass

Specialists of the BSMU Clinic for the first time in the Volga Federal District successfully applied the method of simultaneous surgery on the kidney and heart. A multidisciplinary team of doctors led by the rector of the Bashkir State Medical University of the Ministry of Health of Russia, academician of the Russian Academy of Sciences, Professor Valentin Pavlov operated on and rescued a patient with stage 4 kidney cancer, complicated by the presence of a tumor thrombus of the inferior vena cava. A feature of this clinical case was the spread of a thrombus into the heart cavity with its fixation in the atrium.

"Until recently, such patients were doomed, and technologies when surgery is performed on a stopped heart in cardiopulmonary bypass were used only in large federal cardiology and oncology centers. And today, for the first time in the Volga Federal District, such an operation was performed at the Clinic of our Bashkir State Medical University. A comprehensive program of equipping our medical institutions with modern equipment and training personnel capable of solving complex medical problems helps us to work according to advanced world standards," Valentin Pavlov said.

A 55-year-old resident of Ufa turned to the BSMU Clinic. After a complete examination, she was diagnosed with stage 4 cancer of the right kidney with a complication - tumor thrombosis of the lower vena cava. The thrombus grew so high that it reached the right atrium. Kidney cancer with the spread of a tumor thrombus along the inferior vena cava to the right atrium is a complex form that occurs in only 4-10% of cases and carries colossal risks: from thromboembolism and acute heart failure to vascular compression. The only effective treatment is surgery.

A multidisciplinary surgical team of doctors consisting of oncologists, cardiac surgeons, urologists and anesthesiologists-resuscitators performed an operation on a non-working heart using an artificial circulation apparatus. Surgeons removed the affected organ and completely removed the clot from the inferior vena cava and right atrium. The use of a cardiopulmonary bypass made it possible to minimize the risks of thrombus separation and compensate for blood loss by returning the patient's blood to the bloodstream. An important feature of this case is that with stage 4 cancer and giant tumor sizes with germination, the patient did not have metastasis. Doctors note that this is a biological characteristic of the tumor itself.

"This is an exceptional case when oncology treatment occurs thanks to the joint work of several diverse specialists. Just a week ago, we presented the experience of the BSMU Clinic on the removal of a kidney with a thrombus of the inferior vena cava at a major conference at the N.V. Vishnevsky. Our reports were highly appreciated by the leading specialists of the country. And today we performed such an operation with complication - the germination of a blood clot into the atrium," Marat Urmantsev, MD, head of the oncology department of the BSMU Clinic, said.

For the patient herself, the operation was a real miracle and a return to normal life. The severe symptoms that had plagued her for months began to recede.

"I got to know about the disease after the new year. Severe shortness of breath began, huge swelling appeared. For a long time, the local clinic thought it was a heart, because there were no obvious signs of kidney disease. When my condition worsened and I was sent to the BSMU Clinic, I did not even expect such an attitude and professionalism. The operation went perfectly. In just a couple of days, it became easier to breathe and move. The day before yesterday I still could not move, yesterday I walked with a support on a cart, and today I already walk without support," Tatyana Ivanovna, a patient at the BSMU Clinic, said.

"Today, the technologies used in the BSMU Clinic allow performing the most difficult operations without risk to patients," Arkady Dolganov, head of the cardiac surgery department - a cardiovascular surgeon, said.

Currently, the patient has been transferred to the rehabilitation department of the BSMU Clinic, where she is undergoing a course of physical and therapeutic recovery according to individual protocols.