Mitral Valve Repair Surgery Performed on Two Teenage Girls while the Heart was beating
Probably the first such surgery in Karnataka performed at SDM Narayana Heart Centre
SDM Narayana Heart Center has found a niche amongst very few hospitals in India that can perform a beating heart surgery for heart valve corrections. Managed by Narayana Health, this specialty heart center in Dharwad, was presented two unique cases of mitral valve repair surgery performed on two teenage girls aged 15 and 17 while their heart was beating during the surgery, on May 24th, 2016.
In the conventional method, patients are usually operated on cardio pulmonary bypass with arrested heart (stopping the heart during surgery and connecting to a heart-lung machine). In this case, Dr. Shivaprasad B Mukkannavar, Consultant Cardiothoracic Surgeon, SDM Narayana Heart Centre, Dharwad adopted the technique of performing the heart valve surgery on two beating hearts.
“After administering general anesthesia, the patient is put on cardio pulmonary bypass machine, while the heart is kept beating throughout the surgery. The left chamber of heart is opened and heart valve surgery like repairs are undertaken in beating heart, i.e., without arresting it”, explained Dr. Shivaprasad. While speaking about the benefits, he said, “This technique gives exact 3D anatomy and functional status of the heart valve. The various problems can be accurately addressed while the heart is functioning in front of you. Hence, valve repair surgeries can be performed more effectively. The recovery using this technique is also good. It benefits the patients in early recovery reducing hospital stay”.
Compared to valve replacement, mitral valve repair provides better long-term survival, better preservation of heart function, lower risk of complications, and eliminates the need for long-term use of blood thinners (anticoagulants). If mitral valve replacement was done instead of repair, then the patient would have been put on lifelong anticoagulation drugs. These are the drugs which keep the blood in liquid state and prevent clot formation.
“We have repaired the valves in both the teenage girls considering the fact that both are young and unmarried. They don’t have to take anticoagulant lifelong, which would have been the case if they underwent valve replacement. Mitral Valve repair is technically more complicated where doctors require years of experience and skill to perform this surgery on a beating heart with precision. This innovative technique helped us to understand the functioning of the diseased valve in a better way”, added Dr. Shivaprasad.
The two young girls will now lead a better quality of life. For them, future pregnancies will be safer with no anticoagulation drugs used. They will have a symptom free and long life.
Heart valve diseases are the most prevalent cardiac diseases in India. Most of the patients come in the terminal stage of the disease. Such patients with sick hearts are often rejected by many heart centers due to increased life risk and other cardiac complications. If this surgery was not done then eventually the girls would have gone into irreversible heart failure causing decreased life expectancy and other complications.
“There is lack of awareness among people about Heart Valve diseases. Patients who are on medication do not know that Heart Valve Repair is a recommended procedure and they wait for years, till the condition deteriorates. They then have to go for Heart Valve Replacement not realizing that their very quality of life may be compromised”, said Dr. Shivaprasad. “With timely and accurate diagnosis and advanced surgical techniques, we can effectively perform complex repairs on patients with heart valve disease”, he added.
Heart valve diseases occur when the heart has a narrow and obstructed valve or leaky valve and causes symptoms like palpitation and fatigue. This success story was written by Dr.Shivaprasad B Mukkannavar and his team comprising of Dr.Ganesh Nayak and Dr.Pramod Honnur, Cardiac Anesthetists at SDM Narayana Heart Centre, Dharwad.