New Delhi: A routine investigation for a life-threatening heart condition led doctors at a Delhi hospital to uncover another serious illness in a 64-year-old man — a cricket-ball-sized cancerous tumour in his left kidney.Doctors treated his torn aorta — the body’s main artery — a severely leaking aortic valve and kidney cancer during a single hospital stay, with the doctors claiming it as a first in the world, based on available medical literature.The patient initially complained of severe breathlessness and extreme fatigue even during routine daily activities. Scans revealed a dangerous tear and swelling in his aorta and the leak in the valve. During a CT scan to assess the aorta, doctors detected the cancerous tumour in the kidney. “Fortunately, it was localised,” Dr Pankaj Panwar, additional director, urology, Fortis Escorts Hospital, said.The fact that the tumour had not spread elsewhere made it possible for a multidisciplinary medical team to consider treating all three potentially life-threatening conditions in one go.The team first carried out a complex open-heart procedure to replace the failing valve and repair the aorta. To protect the brain and other organs during the surgery, the patient’s body temperature was lowered and specialised pumps were used to maintain blood flow to the brain.For the aortic repair, the surgeons used the advanced ‘frozen elephant trunk graft’, which combines replacement of the damaged section of the artery with a built-in stent extending into the descending aorta. This approach helped avoid the need for another major aortic operation later, Dr Shiv Kumar Choudhary, executive director, adult cardio thoracic and vascular surgery, Fortis Escorts Hospital, said.Once the patient’s heart was stabilised, the urology team performed a robot-assisted partial nephrectomy, removing the tumour while preserving as much healthy kidney tissue as possible. The robotic approach was chosen to make the surgery minimally invasive, improve precision and visualisation, reduce surgical trauma and support a smoother recovery, particularly after the cardiac surgery.“Performing an open-heart repair and robot-assisted kidney cancer surgery in one go has never been done before, making this a rare medical feat,” Dr Choudhary said.The entire procedure cost around Rs 24 lakh, he added, with specialised devices alone accounting for around Rs 12.5 lakh.The patient, who is now doing well, said he consulted doctors at AIIMS and some other hospitals before deciding to undergo the procedures. “I was mentally prepared for these complex surgeries largely because of my confidence and trust in the doctors,” said the patient, Md Khalid Hussain, who runs a charitable educational trust.
