Removing heart "time bomb", a miracle made by cooperation of liver transplant team and cardiologists

    As is known to all, liver transplant is such a complicated operation, and heart surgery is alsoaccompanied with high risk. To do these two operations at the same time, will it be success No such leading card can be found all over the world, nobody could answer such a question. But as testified by the experience in Beijing University Third Hospital, no miracle cannot be made only that it should be based on a hospital with mighty comprehensive strength. The 60 years old patient with advanced liver cancer visited almost all the famous medical center without any result before he came to the center on March, 2003. His condition was really severe when he was admitted. He had severe jaundice, a great deal of ascites. By CT scan, his mass in the liver was really too big to be removed by traditional hepatectomy, and liver transplant was the only chance of effective treatment. But, by routine MR scan of the liver vessels, it was found that the cancer mass had already infiltrated the inferior vena cava, and the tumor thrombi had already reached right atrium as confirmed also by Doppler Ultrasonography. The thrombi could at any time drop from where it was and embolize the pulmonary artery and cause sudden death. It was a real "time bomb". No leading card could be found for this condition by data retrieval. The procedure was made by the liver transplant team and the cardiologists in our hospital after the careful in-depth discussion. The operation was commenced at 14:30 on March 28, 2003. The extracorporeal circulation was firs made to bypass the blood from vena cava, then the cardiac surgeons opened the heart atrium to totally remove the thrombi in it. Thus, liver transplant could began as routine. The operation was successfully completed at 5am the next day, and the total time spend was 14 hours. The patient was freed from the respirator on the third day after operation, and got through the post-operation course uneventfully. 40 days after the operation, the patient checked out as scheduled satisfactorily.