31-Year-Old Man with Heart Pumping of Merely 20%, Successfully Underwent Complex Emergency Surgery at Wockhardt Hospital During Lockdown
The patient was diagnosed with acute type A aortic dissection that has significant mortality without treatment
In a challenging surgery, his heart valve and the big blood vessel called ascending aorta was changed with an artificial valve and artificial blood vessel respectively
Mumbai: A team headed by Dr. Upendra Bhalerao, Cardiovascular and Thoracic Surgeon at Wockhardt Hospital, Mira Road, gave a new lease of life to a patient who was in acute heart failure with heart-pumping of 20%. The patient has diagnosed with acute type A aortic dissection, there was an intimal tear in the largest blood vessel arising from the heart (aorta), and that supplies blood to all the vital organs. He underwent a complex surgery, amid lockdown, and soon, will resume his daily activities.
Life was smooth until 31-year-old Vipul Narkhede, a resident of Boisar, Palghar District, Maharashtra, who runs a travel agency, suddenly encountered shortness of breath and chest pain. He fainted and was brought to Wockhardt Hospital, Mira Road, on a ventilator, in the middle of the night. The patient presented with acute onset chest pain similar to a heart attack, low blood pressure, and was critical. He was in heart failure with heart-pumping of barely 20-25%. He underwent an echocardiogram and CT scan that revealed he had acute type An aortic dissection.
Dr. Upendra Bhalerao, Cardiovascular and Thoracic Surgeon at Wockhardt Hospital, Mira Road, highlighted, “Acute type A aortic dissection is a rarely occurring aortic pathology in young individuals. This suggests that there is an intimal tear in the largest blood vessel (Aorta) which arises from the heart and supplies blood to all the vital organs including the brain, intestine, kidneys, and limbs. Due to the tear in the aorta, all the vital organs are at risk of malperfusion and there is a high risk of sudden death due to bleeding in the chest following rupture of the aorta. Acute aortic dissection without treatment has a mortality of 95-98%. Hence, the patient was scheduled for emergency aortic valve replacement and aortic root replacement surgery immediately
Dr. Bhalerao added, “This is a complex heart operation wherein the heart valve and the big blood vessel called ascending aorta is changed with an artificial valve and artificial blood vessels respectively. During the surgery all the torn diseased part of the aorta and the aortic valve was removed and replaced with artificial ones. As the normal circulation to the coronaries and all the organs are established the heart function subsequently improves. The surgery lasted for 10 hours, and the patient had a critical post-operative course. After 10 days of stay in the ICU and normal ward, the patient recovered completely and was discharged on the 14th day. And soon, he will resume his daily activities. At he follows up his heart pumping is 45-50% and all other parameters are near normal
“During the lockdown, I suddenly encountered chest pain at night and was admitted to Wockhardt Hospital, Mira Road, because of the tear in my blood vessel, and I fainted too. My family was worried as my condition had worsened and become fatal. But I was fortunate to get timely treatment at the hospital, and I thank all the doctors for saving my life,” said patient Vipul Narkhede.
“In the time of coronavirus pandemic, when such patient is brought to the hospital, we do not know the infective status, contact history, or exposure of the patient. Emergency cardiac surgery cannot be postponed and needs to be done accepting the risk to the treating team and taking due precautions. Saving the life of such a patient is the primary aim,” concluded Dr. Bhalerao.
