Andrey Kaprin: “Be healthy – this is the biggest reward for us”

A unique operation performed on October 6, 2020 at the Botkin Hospital by an interdisciplinary team of doctors from the Herzen Institute of Medical Sciences and Botkin State Clinical Hospital was completed successfully: today the patient is preparing for discharge.

– How can I thank the doctors ?- asks the rescued patient from Karachay-Cherkessia. – After all, you gave me a second life.

– Be healthy, – says Academician of the Russian Academy of Sciences Andrey Kaprin, – for us, doctors, this is the greatest reward.

1.5 years ago, the patient underwent surgery for a tumor of the right kidney. In the summer, the condition worsened.

Doctors at the place of residence after the examination confirmed a relapse of the disease: the tumor of the right kidney grew into a huge tumor thrombus.  It started from the affected kidney, filled the inferior vena cava, hepatic veins and heart cavities, disrupting the inflow and outflow of blood from the heart.

The drama of the situation was that despite a healthy heart, the patient died of heart failure. The woman was refused in several Russian and European clinics and was hospitalized only in the P.A. Herzen Moscow Research Oncological Institute.

Considering that the patient was diagnosed with kidney, inferior vena cava, hepatic veins, vessels of the lower extremities and heart, it became obvious that it would be possible to try to save the woman only by combining the potential of two leading clinics in Moscow and Russia – the Herzen Institute and Botkin Hospital. The chief physician of the Botkin Hospital, a brilliant surgeon, corresponding member of the Russian Academy of Sciences Alexey Shabunin immediately responded to the offer of colleagues to conduct a joint operation.

Specialists of the two clinics held a joint consultation, formed a surgical team, which included oncourologists, vascular surgeons, cardiac surgeons, abdominal surgeons, hematologists, anesthesiologists and perfusiologists of the highest level.

Oncourologists and abdominal oncosurgeons were the first to begin the operation, having isolated the affected kidney, all the main vessels of the abdominal cavity and retroperitoneal space from the adhesive process. Then, after the removal of the kidney, the work was continued by cardiac surgeons. At this stage, an artificial blood circulation device (AIC) was connected, which, replacing the work of the heart, allowed doctors to open it and completely remove the blood clot from the right atrium.

During the operation, there was a danger that a blood clot or part of it would come off, this would entail irreversible consequences for the patient’s health. If at least one fragment, one cancer cell, broke off from this huge blood clot and flew away along the vascular bed, the patient would receive the most severe life–threatening complications – a heart attack or stroke. Therefore, surgical intervention was performed with maximum precautions.

Only after vascular isolation, the kidney was removed and the AIC was connected, the myocardium was dissected, the heart was opened, the thrombus and its parts were sequentially removed from the right atrium, hepatic veins, vessels of the lower extremities and the inferior vena cava.

This was followed by a stage of precision restoration of the myocardium and all vessels, after which cardiac activity was restored and the AIC was turned off. The operation lasted 8 hours.

Today, three weeks later, the patient feels well and is going home. Both managers came to visit her before discharge: Andrey Dmitrievich Kaprin and Alexey Vasilyevich Shabunin.

– For surgeons, a successful operation is considered when the patient is already on his feet and can do everything on his own – shares Academician Kaprin.- This is a really good result.

For three months, the patient will rest and gain strength, then oncologists will call her for a control check and, based on the results, will recommend further tactics.

– The operation was carried out at the highest professional level, – Academician Kaprin emphasized. – We managed to remove a very unusual tumor in the form of a huge blood clot whole, without destroying the structure, so we really hope for a further positive prognosis.

Press Service of the FSBI NMIC of Radiology of the Ministry of Health of Russia