19 May 2010
It is said to be the first–of–its–kind surgery in India. The patient underwent a cardiac bypass and a liver surgery one after the other without a second’s break – all of it in seven hours.
A team of experts led by cardiac surgeon Dr Vivek Jawali of Fortis Hospital and Dr Ramcharan Thiagarajan, consultant surgical GI and hepato–pancreatic biliary surgeon, performed a combined cardiac bypass and liver tumour surgery on a 63–year–old Nigerian patient.
Saidu Abubarkar, retired executive director of Nigerian Television Authority, was experiencing for almost eight years breathing problems and weakness while walking. On consulting doctors in Nigeria, he was advised to go for a second opinion as he was diagnosed with heart trouble. After visiting four countries, he decided to come to India after a friend told him about cardiac expertise available in Bangalore.
Abubarkar was diagnosed with coronary artery disease, with severe left ventricular dysfunction, and had six blockages. He was recommended a bypass surgery. During his preoperative evaluation, he was diagnosed with compensated liver disease with a malignant tumour in the right lobe of the liver. Abubarkar was known to be positive for Hepatitis B virus and advised to take antiviral medication for the same. The elevated liver marker was suggestive of liver cancer and, therefore, he was also advised a liver resection.
“Abubarkar’s case was risky and complicated. The patient’s heart was weakened with six blockages; he was hypertensive, diabetic, had cirrhotic liver and liver tumour. We had to carefully understand and evaluate Abubarkar’s case to ensure he received appropriate treatment, and both his liver and cardiac problem was taken care of,”said Jawali, chief cardiothoracic surgeon, Fortis Hospitals.
“We have done many combined cardiac surgeries in the past, but a cardiac bypass and a liver surgery of this nature is, to my knowledge, one of its kind which hasn’t been recorded in India. Both the surgeries were of high risk, and to perform both in the same sitting was a challenge which our team took and successfully accomplished,”Jawali added.
“The tumour was deep inside and on the back of the liver. Due to its location, the patient 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 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.
Abubarkar has recovered fast. In fact, he’s been discharged from hospital and is ready to go back to his hometown in a few days. “I didn’t believe when my doctors said I had a heart problem. I have been quite active all my life playing tennis, football, etc. I have 10 children and 12 grandchildren. I love to spend time with my grandkids.’’ “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. A few Nigerian doctors then referred me to India. Bangalore was the perfect choice of all the Indian cities as we researched medical expertise available in the city,”he added.