Southern States - Karnataka-Bangalore

Twin surgery on heart, kidney saves man

By Our Staff Reporter

BANGALORE April 21. On April 13, a five-hour twin operation saved a patient's heart and kidney.

First, a Coronery Artery Bypass Grafting (CABG) was done on a beating heart, i.e the organ was not stopped or a heart lung machine used. A little later, the patient underwent a radical nephrectomy, by which his cancerous left kidney was removed.

Doctors at the Wockhardt Hospital and Heart Institute (WHHI) — where this took place — told presspersons here that they did not know if such sequential surgeries had been performed elsewhere.

Although they had performed 99 such CABGs on beating heart earlier, the twin surgery was a first, they added.

R.Prabhakaran, consultant cardiovascular surgeon at WHHI, said Anand, the 56-year old patient, had an angioplasty 12 years ago. "The routine coronary angiogram showed severe triple vessel coronary disease requiring immediate bypass surgery." The checks also revealed a large renal tumour in two-thirds of his left kidney.

Consultant Urologist, Dilip Dhanpal, said this was disturbing because "...the patient showed no symptoms, no blood in the urine, no loss of weight (usually indicates later stage cancer).

This discovery was extremely fortuitous,'' he said.

For Mr. Anand to live longer and healthier, the renal cell carcinoma needed early removal. Hence, with the latter's and his family's informed consent, the surgeons decided to proceed.

Dr. Prabhakaran believed Mr. Anand had a 99 per cent chance of survival because the cancer was confined to the kidney.

The doctors said that coronary bypass on beating heart led to the patient's faster recovery. He needed shorter ventilator support. A week after the twin surgery, Mr. Anand was declared fit to go home.

In surgeries using the heart-lung machines, there was a bloodless field to operate. But there was immunosuppression, where the body's natural fighting system was disabled for a time. Chances of infection were higher, so was the possibility of strokes and neuro cognitive defects. Hospital stay was longer. "And a three to four weeks gap is needed before doing a radical nephrectomy or any major surgery,'' the doctors said.

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