Udupi: Stopping a patient’s entire blood circulation to remove a tumour is extremely rare — and doctors at Kasturba Hospital, Manipal, did just that to treat a 63-year-old man from Shivamogga whose kidney cancer had reached the right chamber of his heart.Scans showed a large tumour in his left kidney with a tumour thrombus — a solid extension of the cancer — that had travelled up the inferior vena cava into the heart’s right upper chamber.The patient was admitted under Dr Arun Chawla, professor and head of unit, department of urology. With co-existing diabetes, high blood pressure, a thyroid condition, and mild heart disease, he was first stabilised by cardiology and endocrinology teams. The surgery was planned jointly with the department of cardiothoracic and vascular surgery (CTVS).On June 17, two teams carried out a 12-hour operation. The urology team opened the abdomen, removed the kidney, and freed the tumour from the vein. The CTVS team opened the chest, connected him to a heart-lung machine, and cooled the body to 22°C to protect vital organs as circulation was completely stopped — total circulatory arrest.Working within a narrow window, surgeons opened the right atrium and inferior vena cava together and removed the tumour in one continuous piece. Clearance was confirmed using a thin camera.The heart chamber was closed, the vena cava repaired, and circulation restarted. The patient was rewarmed, weaned off the heart-lung machine, and stabilised.He remained on ventilator support for 12 hours, was off it successfully, was mobile within three days, and was discharged in stable condition about two weeks later.The case was led by Dr Shyam K Ashok and Dr Ganesh Kamath (CTVS) and Dr Arun Chawla (urology), with Dr GV Srinadh. Anaesthetists Dr Vijaykumar and Dr Sai Krishna, the perfusion team, and the departments of cardiology, critical care, and endocrinology supported the procedure.
