In a recent incident, doctors at Manipal Hospitals, Baner, successfully saved the life of a 31-year-old female patient suffering from multiple heart conditions. The young patient had a history of two major heart surgeries and had come to the hospital in critical condition with complaints of arrhythmias and blackouts. Upon further evaluation, it was found that her pacemaker was not functioning properly. A 2D Echo also revealed that her heartbeat was irregular. Dr. Abhijit Joshi immediately decided to replace the pacemaker to treat her arrhythmia. As her valves were also not functioning properly, Dr. Shrirang Ranade and his team also perform an emergency double heart valve replacement surgery on both sides to save the life of the patient.
A heart valve replacement surgery is a procedure in which the heart valves are replaced with mechanical valves to restore the heart’s ability to pump blood efficiently. In this unique case, the patient had undergone two major heart surgeries in the past. The first was a mitral valve replacement (MVR) surgery, and the other surgery was for fitting a pacemaker for her low heartbeat in 2015. Initially, the doctors decided to replace the pacemaker to restore her heartbeat, but there was no improvement in her condition due to the partial blockage of the heart valve. As the valve was about to get stuck, it was causing a back pressure effect on the lungs and liver.
Dr. Abhijit Joshi, Consultant and HOD, Cardiology, Manipal Hospital, Baner-Pune, said, “The patient had come to us in a critical condition with the complaint of breathlessness and blackouts. It was surprising to see that a young patient was suffering from such severe heart conditions that she needed a pacemaker to support her heart. We were able to identify the complications quickly in the ICU and treat her with a high medication dose to keep her blood pressure within the normal range. Despite replacing the pacemaker, there were no signs of improvement, and her heart rate was deteriorating. After repeating the 2D Echo, it was revealed that the previously replaced valve was almost on the verge of completely choking and other left-sided valve had a moderate leak. Thanks to the support of Dr. Bhushan Nagarkar, ICU Head, Dr. Suhas Sonawane, Cardiac Anesthetist along with Cardiac Perfusionists, Samrat Bagal and Nalini Awgune, we were able to provide the best treatment to the patient and give her a new life.”
Commenting on the severity of this case, Dr. Shrirang Ranade, Consultant and HOD, Cardiothoracic and Vascular Surgery, said, “The case was extremely challenging for us as the patient had already suffered major damage to the heart and then her liver and lungs got affected. Previous surgery had caused the heart to be adherent to the surrounding organs, separating the heart and putting the patient on cardiopulmonary bypass was in itself a challenge. Also, the removal of the previously implanted faulty valve without causing any damage to the heart was a major task. Due to her preoperative critical condition and high-risk status, the surgery lasted for around 8 hours overnight. Her heart was too weak immediately after the operation and had to be supported on the CPB (Cardiopulmonary Bypass Machine) till it recovered and could support the patient all by itself. We also supported her with ventilatory support for 5 days to prevent multiorgan damage and was shifted out of ICU after 14 days.”
