Combined cardiac bypass and liver tumor surgery performed on 63-year-old Nigerian

Jun 8 2010

Adding another feat to the history of cardiothoracic surgery at Fortis Hospitals Bangalore, the team of experts led by noted Dr. Vivek Jawali, Chief Cardiothoracic Surgeon and Dr. Ramcharan Thiagarajan, Consultant Surgical GI & Hepato-Pancreatic Biliary Surgoen has performed a combined cardiac bypass and liver tumor surgery on a 63 year old Nigerian.

This is one the most rare and complicated case where a patient underwent a cardiac bypass and a liver surgery at the same time. Mr. Saidu Abubarkar, retired Executive Director of Nigerian Television Authority had visited Fortis Hospitals Bangalore couple of months ago for a cardiac consultation. He was diagnosed to have coronary artery disease with severe left ventricular dysfunction and had 6 blockages and was recommended for a bypass surgery. During his preoperative evaluation he was diagnosed to have compensated liver disease with a malignant tumor in the right lobe of the liver. He was known to be positive for Hepatitis B virus for which he was advised to take antiviral medication. The elevated liver marker was suggestive of Liver cancer and was advised for a liver resection.

"This is a very risky and complicated situation where the patient's heart was weakened with 6 blockages, he was hypertensive, diabetic, cirrhotic liver and had liver tumor. We had to carefully understand and evaluate Mr. Saidu's case to ensure that he receives the appropriate treatment and both his liver and cardiac problem was taken care of" said Dr. Vivek Jawali.

"We have done many combined cardiac surgeries in the past, but a cardiac bypass and a liver surgery of his nature is to my knowledge is one of its kind in our country. Both the surgeries were high risk surgery and to perform both in the same sitting was a challenge which our team took and successfully accomplished" added Dr. Vivek Jawali.

"The tumor was resting deep inside and back of the liver and due to its location he was not a candidate for other palliative options and surgery was the best option. The liver had cirrhosis on visual examination. About 20 - 25% of his liver was resected along with the tumour completely with adequate surgical margin. However since his liver is already affected by Hepatitis B and has cirrhosis, he has to ultimately get a liver transplant at a later stage" said Dr. Ramcharan Thiagarajan.

"The advantages of the combined surgery are that the patient need not have to wait to recover from his heart surgery and then go through rigmarole of major liver surgery and recover again, faster recovery, financial benefit of one surgery rather two and he need not have to worry about the spread of Liver cancer during the waiting time. With the clinical expertise and facilities available at our institution, we were successful in handling the criticality of the situation and perform both the surgeries without much blood loss and help the patient recover at the earliest" added Dr. Ramcharan.

"I visited Saudi Arabia, Egypt, South Africa and London apart from doctors in Nigeria. Some doctors told me my condition was too critical and surgery would be risky for me. Learning about the expertise available at Fortis Hospitals India we knew it was the perfect choice for my treatment. I am thankful to the doctors at Fortis Hospitals and wish to come here for any further medical treatment if required" said Mr. Saidu.