Media Release
Udupi, July 6: Doctors at Kasturba Hospital, Manipal, a unit of the Manipal Academy of Higher Education (MAHE), have successfully treated a 63-year-old man from Shivamogga whose kidney cancer had extended through a major vein into the right chamber of the heart, in one of the most complex oncological procedures undertaken at the institution.
The patient initially presented with abdominal pain of one month’s duration. Investigations revealed a large malignant tumour in the left kidney with a tumour thrombus—an extension of the cancer—that had travelled through the inferior vena cava (the body’s largest vein carrying blood back to the heart) and reached the right atrium. Doctors said this represents an advanced, potentially life-threatening form of cancer spread if left untreated.
The patient was admitted under Dr Arun Chawla, professor and head of unit, Department of Urology, and evaluated jointly with the Department of Cardiothoracic and Vascular Surgery (CTVS). Given his comorbidities, including diabetes, hypertension, thyroid disorder and mild cardiac disease, he was first assessed and optimised by cardiology and endocrinology teams prior to surgery.
On June 17, 2026, two specialised surgical teams operated together in a single theatre for a demanding 12-hour procedure. The urology team first accessed the abdomen, removed the cancerous kidney, and dissected the tumour along the vein.
The CTVS team then performed a sternotomy and placed the patient on a heart-lung machine, which temporarily takes over the function of the heart and lungs. The body temperature was gradually reduced to 22°C to protect vital organs while blood circulation was completely stopped—a procedure known as total circulatory arrest—allowing safe removal of the tumour from the inferior vena cava and right atrium.
During this critical phase, surgeons opened the heart and vena cava simultaneously and, in a coordinated effort, removed the entire tumour in a single piece without fragmentation. Complete clearance was confirmed using an intraoperative camera inspection of the vessel.
Following removal, the heart chambers were closed, the vena cava repaired, and circulation restored. The patient was then gradually rewarmed and weaned off the heart-lung machine, after which the urology team secured the remaining vascular structures.
Doctors described circulatory arrest procedures as extremely rare and high-risk, requiring precise coordination between cardiac surgery and perfusion teams, where even minor errors can lead to serious neurological or organ damage. The patient’s recovery without neurological complications was described as a significant clinical achievement.
Post-surgery, the patient remained on ventilator support in the intensive care unit for 12 hours before being successfully extubated. His recovery progressed steadily, with mobility returning within three days, and he was discharged in stable condition after around two weeks, returning home to Shivamogga.
The surgery was led by Dr Shyam K Ashok and Dr Ganesh Kamath (CTVS), along with Dr Arun Chawla (Urology), and Dr GV Srinadh, Assistant Professor (Urology). The anaesthesia team included Dr Vijaykumar and Dr SaiKrishna, supported by the perfusion team and specialists from cardiology, critical care and endocrinology.
“When a kidney tumour extends into the heart, it transforms a routine cancer surgery into a highly coordinated operation between two major surgical teams working as one. Careful planning, teamwork, and institutional readiness made this possible, and seeing the patient recover well is deeply satisfying,” said Dr Arun Chawla.
“Since its inception, Kasturba Hospital, Manipal, has been committed to treating critically ill and high-risk patients. Such complex surgeries are made possible by the expertise of our consultants and the advanced infrastructure of our institution, enabling safe and world-class care for patients who need it most,” said Dr Sudhakar Kantipudi, chief operating officer, MAHE Teaching Hospitals.