Novosibirsk doctors operated on a patient with critical stenosis of the aortic valve and cancer at the federal state budgetary institution "National Medical Research Center named after Academician E.N. Mashalkin" from the Ministry of Health of Russia, a patient who previously suffered from cancer came to the Ministry of Health of Russia. During the examination, he was diagnosed with two malignant intestinal tumors and a critical degenerative aortic valve stenosis. Usually, such a combination of pathologies becomes the basis for declaring the patient inoperable. Moreover, if there was a delay in treatment, each of the diseases threatened death. The problem was that with such stenosis and after its surgical repair, the treatment necessarily includes antiplatelet and anticoagulant drugs. Against this background, the patient is already experiencing bleeding from tumor centers, which may become uncontrollable. If we had started with tumor removal, it is likely that the heart would have stopped while the anesthesia was administered. "In the past, this was a fairly rare combination of pathologies. Now this is not our first patient, they are becoming more and more common. There are no clinical recommendations for their management, because it is impossible to say which risks are higher in such a situation - bleeding or blood clots. It's a "double-edged sword." Only an experienced multidisciplinary team can weigh the possibility and apportion the risk only when it has a chance of saving a life. In such cases, we develop a safe action strategy, which will later become an algorithm," explained X-ray endovascular surgeon, head of the Endovascular Surgery Research Institute Dmitry Zobarev. The tactics were determined by a board of oncologists, heart surgeons, anesthesiologists and cardiologists. The treatment was carried out in three stages. First, the endovascular team led by Dmitry Zobarev performed a balloon valve repair. The procedure did not eliminate all the problems, but it did temporarily reduce the stenosis so that the patient could tolerate anesthesia for cancer surgery.

Novosibirsk doctors operated on a patient with critical stenosis of the aortic valve and cancer at the federal state budgetary institution "National Medical Research Center named after Academician E.N. Mashalkin" from the Ministry of Health of Russia, a patient who previously suffered from cancer came to the Ministry of Health of Russia. During the examination, he was diagnosed with two malignant intestinal tumors and a critical degenerative aortic valve stenosis. Usually, such a combination of pathologies becomes the basis for declaring the patient inoperable. Moreover, if there was a delay in treatment, each of the diseases threatened death. The problem was that with such stenosis and after its surgical repair, the treatment necessarily includes antiplatelet and anticoagulant drugs. Against this background, the patient is already experiencing bleeding from tumor centers, which may become uncontrollable. If we had started with tumor removal, it is likely that the heart would have stopped while the anesthesia was administered. "In the past, this was a fairly rare combination of pathologies. Now this is not our first patient, they are becoming more and more common. There are no clinical recommendations for their management, because it is impossible to say which risks are higher in such a situation - bleeding or blood clots. It's a "double-edged sword." Only an experienced multidisciplinary team can weigh the possibility and apportion the risk only when it has a chance of saving a life. In such cases, we develop a safe action strategy, which will later become an algorithm," explained X-ray endovascular surgeon, head of the Endovascular Surgery Research Institute Dmitry Zobarev. The tactics were determined by a board of oncologists, heart surgeons, anesthesiologists and cardiologists. The treatment was carried out in three stages. First, the endovascular team led by Dmitry Zobarev performed a balloon valve repair. The procedure did not eliminate all the problems, but it did temporarily reduce the stenosis so that the patient could tolerate anesthesia for cancer surgery.