In a remarkable medical achievement, a team of cardio surgeons headed by Dr. Divakar Bhat at Aster RV Hospital, JP Nagar in Bengaluru performed a complex open heart surgery on a 40-year-old Nepalese woman, saving her life after she suffered from severe heart complications due to rheumatic heart disease.
The patient had undergone heart valve replacement surgery two decades ago, but her condition had recently worsened, with symptoms as severe breathing difficulties and swelling in her legs. Patient Mahima (Name changed) had been living a healthy life post her first heart surgery. She began to experience recurrent breathing problems and fluid overload in the legs over the last three to four years.
Despite optimal medical management, her condition continued to deteriorate. After additional research, it was found that her heart had grown to more than twice its typical size, with the right atrium measuring 10–11 cm and the left atrium at 7-8 cm. Moreover, the second heart valve was found to be severely leaking, while the original valve replacement was still functioning properly.
“Redo surgery in such cases is always a high-risk procedure, but with the advanced surgical techniques and technology we have, we were confident we could help her. The real challenge was not only in replacing the defective valve but in reducing the size of the heart, which had grown so large that it could lead to reduce heart function and cause severe implications” said Dr. Divakar Bhat, Consultant - CTVS Surgery, Aster RV Hospital, JP Nagar, Bengaluru.
In order to reopen the patient's chest, the surgical team carefully planned a redo sternotomy, which entailed replacing the sick valve with a new metallic one while maintaining the previously replaced valve. To reduce the enlarged heart, the surgeons employed a technique akin to folding a saree with precision stitches, reducing the heart’s size by half while maintaining its functionality.
Despite the complexity and risks involved, the surgery was a success. The patient was discharged within days of the procedure. She made a swift recovery, with her breathing significantly improved and her leg swelling reduced.
“This case is especially rare, as rheumatic heart disease is becoming less common with modern medicine. However, when it does occur, it can lead to life-threatening complications like the one we faced here,” doctor added.
As a preventive measure, the team also placed an epicardial bipolar lead to address potential future issues such as heart block, a complication that could arise from the placement of the metallic valve. The patient, whose family had faced financial challenges, received financial assistance from various sources, ensuring that the life-saving surgery could proceed without delay, ensuring that the patient can look forward to a full, healthy life ahead.
Speaking on having undergone the heart operation for the second time successfully, patient Mahima said, “At first I was a little scared for the operation as it was happening for the second time for me. My husband’s boss where my husband works as a security guard assured about the hospital and doctors here and provided all the support to me.
I was feeling so comfortable after the operation was done as I was able to see the smile on my Husband’s face. I did not know the details and complications of the operation but, the doctor was kind and made us feel so comfortable and I am feeling so good because he not only treated my heart but also made my heart feel good with the second operation”