Republican Clinical Oncology Center and 抖阴APP导航 University Clinic perform unique combined surgery on heart and cancer patient
The medical story began as a complex puzzle within the walls of the Republican Clinical Oncology Center and ended at the University Clinic. This is an example of the interaction of leading experts from two clinics who united to save a person who found himself in a seemingly hopeless situation.
The story of this patient is a vivid example of how modern medicine, having turned into a well-coordinated orchestra of oncologists, cardiac surgeons and anesthesiologists, is able to defeat two deadly threats at once.
It all began in February 2025 with a routine gastroscopy. Behind the diagnosis of stomach ulcer, the endoscopist saw something more – a suspicion of a malignant tumor. The first biopsies brought alarming news – stomach cancer.
The patient was immediately sent to the Republican Clinical Oncology Center (RCOC). It seemed that the path was clear. But medicine rarely follows simple scenarios.
The doctors of the RCOC, headed by the head of the oncology department No. 2 Tom Sharapov, developed a clear plan. However, the next additional examination revealed a second, hidden enemy: critical aortic stenosis – a life-threatening heart defect, in which any operation is practically impossible.
It was at this point that the cardiologist of the RCOC, Luiza Gapar, joined the case. Her verdict was harsh: “High risk of intraoperative complications. It is impossible to operate!” But she did not simply state the fact, but became the key link, initiating an interdisciplinary consultation with colleagues from the University Clinic.
It was then that the heavy artillery of modern medicine – a multidisciplinary consultation – took up the matter. Oncologists, cardiac surgeons, cardiologists, anesthesiologists gathered at one table to find the only right way. Their verdict was bold and brilliant: to untie this Gordian knot by dividing it into two stages.
A strategic decision was made to conduct both stages of treatment 鈥� 鈥嬧�媜ncology and cardiac surgery 鈥� at the University Clinic. This choice was due to the key advantage of the clinic 鈥� its multidisciplinary nature. The unique infrastructure which unites powerful surgical, cardiac surgery and intensive care departments under one roof, made it possible to find everything necessary to save the patient in one place. This eliminated the need to move him between the facilities, guaranteeing continuity of treatment and maximum safety at all stages.
On May 26, Tom Sharapov and the deputy chief medical officer for surgery of the University Clinic Marat Bakirov joined forces in the operating room for precision work on the stomach. Minimally invasive proximal gastric resection was performed. Part of the stomach with the tumor and regional lymph nodes was removed.
But the main battle was just beginning. The most dangerous period was the postoperative period. A patient with a critical heart defect, who had just undergone major surgery, was transferred to intensive care under the close supervision of the head of the department Ilgam Saubanov and his team.
Resuscitators and cardiologists literally waited at his bedside, monitoring the slightest fluctuations on the monitors: whether the pulse had dropped, whether the blood pressure had dropped, whether the ECG readings were distorted. His worn-out heart was working at its limit, and every minute was a test. It was necessary to maintain a delicate balance of fluids and medications so as not to overload the myocardium, but at the same time ensure adequate blood supply to the healing tissues.
Their joint work became an example of the highest professional skill. The heart, despite all pessimistic forecasts, endured. A few days later, the crisis passed, and the patient was transferred to the general ward.
The histologists confirmed: high-grade adenocarcinoma, but the resection margins were clean, the lymph nodes were not affected – this was a huge victory.
The final chord in this symphony of salvation was to sound in the X-ray operating room. It was the turn of cardiac surgeons, X-ray surgeons and their high technology – transcatheter aortic valve replacement (TAVI).
This is not a regular operation with opening the chest and stopping the heart. This is a jewelry procedure of the 21st century, reminiscent of magic. Such an operation is carried out in a specially equipped operating room with a modern X-ray machine (angiograph) for detailed visualization and control of the working process.
Head of the Cardiac Surgery Department Anton Omelyanenko and Head of the Department of X-ray Endovascular Diagnostics and Treatment Albert Alkhazurov inserted an introducer (a special tube) into the femoral artery through a tiny puncture in the groin, through which a valve delivery system was carried to the patient’s heart on a thin, flexible “conductor” (it serves as “rails” along which all other instruments are advanced). At its end, in an assembled state, on a special metal frame (stent), there was a complex biological valve implant with a diameter of 27.5 mm. The team of cardiac surgeons carried it through all the obstacles right to the epicenter of the problem – to the non-functioning heart valve.
And then a miracle of engineering and medical skill happened: on the surgeon’s command, the artificial valve on the beating heart without stopping blood circulation was implanted in the aortic position. It opened in the lumen of the aorta at the outflow tract of the heart, instantly taking over the function of a vital valve that had barely let blood through for years. The new valve began to work immediately. The heart finally breathed freely. And here history came full circle. After a brilliantly performed TAVI procedure, the patient again, like an old friend, fell into the reliable hands of Ilgam Saubanov and his team. This time, thanks to the minimal invasiveness of the modern technique, the observation went smoothly, without the previous worries and stress. Literally the next day, stable and with a perfectly functioning new valve, he was transferred to a general ward and could calmly move around the cardiac surgery department on his own, completing his dangerous journey through the intensive care units.