April, Jaipur: Re-operative cardiac surgeries are being performed with increasing frequency due to continuing advances in heart surgery and improved life expectancy. However, third-time valve replacement of the heart remains a rare & extremely risky surgery. Narayana Multispecialty Hospital – Jaipur’s Cardiac team achieved a rare feat by successfully performing valve replacement surgery on a patient, who needed it for the third time.
Lakhani Lal (name changed), a 61-year-old patient, was suffering from Rheumatic Heart disease which had destroyed his heart valves. In the last 15 years, the patient had already undergone replacement of the valves twice – the first time both valves were replaced and the second time one was replaced and the other was repaired in which tissue ingrowths which were obstructing the valve (known as pannus formation) were surgically removed.
However, the patient developed excess tissue in growth in the ‘repaired valve’ again requiring an open-heart surgery for the third time. Since it was a risky procedure, he was refused by most regional hospitals and came to Narayana to seek treatment. At Narayana Multispecialty hospital, the patient’s condition was reviewed after conducting multiple lab investigations and diagnostics. The results revealed obstruction in the affected valve due to repeat ingrowth of tissues, which was causing the patient severe breathlessness and palpitation. If left untreated, with time it could prove fatal, hence the Cardiac Surgery team at Narayana decided to perform a valve replacement surgery of the affected valve post ascertaining the fitness of the patient.
The Cardiac Surgery team at Narayana headed by Dr. CP Srivastava, Chief Consultant & HOD – Cardiac Surgery performed the extremely challenging surgery of opening the heart for the third time and replacing the damaged valve. Since the patient had already undergone heart surgeries twice in the past, internal scar tissues between the structure of the chest made it quite challenging to re-enter the chest and perform the surgery without damaging parts of the heart like cardiac chambers, coronary arteries etc. The four-hour long surgery proved to be a success and the patient was discharged within a week.
“Replacing heart valves post taking out the damaged valve in a re-do surgery requires extensive experience & precision as it is an extremely complicated procedure carrying risks of profuse bleeding if any undue damage is done during surgery. Even opening of the chest requires special skills, as it could prove fatal if any damage is done to the heart chambers” said Dr. CP Srivastava who is an expert in re-do surgeries. Dr. Mala Airun, Zonal Clinical Director, Narayana Multispeciality Hospital said “It has been seen that patients who have high-risk factors or who have to undergo a complex re-do surgery do best at specialized centers such as ours where the surgical and support team has a lot of experience. We are happy that the team could successfully perform the surgery and save the patient”.
On his 1st post-surgery visit, the tests conducted showed the excellent functioning of the heart and replaced the artificial valve.