Thane doctors give new lease of life to woman suffering from life-threatening heart condition

A 52yearold womans worsening breathlessness turned out to be a complex and potentially lifethreatening heart condition but doctors in Thane gave her a new lease of life in time Her condition meant a failing artificial valve a large clot inside the heart severe pulmonary hypertension and disease affecting multiple heart valvesShe was successfully treated through a rare and highly complex cardiac operation known as the Commando procedure helping her regain her quality of lifeThe woman had undergone mitral valve replacement in 2020 Over time she developed increasing shortness of breath that began affecting her daily activities She consulted Dr BC Kalmath Director of Cardiac Sciences KIMS Hospitals Thane for her worsening symptoms and was treated by the Department of Cardiac Sciences at the hospital Detailed investigations revealed severe narrowing of her previously implanted mitral valve a large clot in the left atrium disease of the aortic valve leakage of the tricuspid valve severe pulmonary hypertension and an extremely small aortic root necessitating a highly complex redo surgeryldquoThis was an exceptionally highrisk case because multiple cardiac problems had developed simultaneously The patient had a failing prosthetic mitral valve a large clot within the heart severe pulmonary hypertension and involvement of multiple valves all in the setting of a previous heart surgery Careful planning multidisciplinary expertise and timely intervention were critical to achieving a successful outcome Cases like these highlight the importance of early evaluation when symptoms such as breathlessness begin to worsenrdquo said Dr BC KalmathThe surgery was led by Dr Saumya Sekhar consultant Cardiothoracic amp Vascular Surgeon in association with Dr Leena Tayshete Cardiac Anaesthetist at the hospitalldquoRedo heart surgeries are among the most demanding procedures we perform In this case the challenge was amplified by the patientrsquos previous surgery severe pulmonary hypertension the large clot within the heart and extremely restricted space available for valve replacementrdquo said Dr SekharFollowing careful reentry into the chest the surgical team determined that a conventional valve replacement would not provide adequate access to safely address the patientrsquos complex anatomy The team therefore proceeded with a Commando procedure one of the most technically demanding operations in cardiac surgery reserved for highly selected casesThe surgery involved reconstructing the heartrsquos central fibrous structure that connects the aortic and mitral valves allowing surgeons to implant appropriately sized replacement valves despite the patientrsquos difficult anatomy The diseased mitral and aortic valves were replaced with mechanical prosthetic valves while the leaking tricuspid valve was repaired during the same operationldquoWe were not just replacing damaged valves We had to reconstruct the heartrsquos central supporting framework before new valves could be implanted safely Procedures of this complexity are rarely required but they can be lifesaving when conventional surgery is not enoughrdquo explained Dr aSekharOne of the most encouraging moments during the operation came when the heart resumed a normal rhythm on its own after blood flow was restored The patient was subsequently weaned off the heartlung machine with minimal medication supportHer recovery was smooth She was taken off ventilator support on the first day after surgery started walking on the fourth postoperative day and was discharged home on the eighth day A followup echocardiogram showed excellent function of both newly implanted valves with smooth blood flow and no leakage around the prosthetic valvesldquoThe Commando procedure is among the most technically demanding operations in cardiac surgery and is performed only in selected patients where conventional valve replacement is not sufficient Given the complexity of this redo surgery and the patientrsquos multiple risk factors achieving such a positive recovery is extremely rewarding for the entire teamrdquo said Dr SekharThe successful outcome highlights how advanced reconstructive cardiac techniques can offer hope even in some of the most challenging redo heart surgeries providing patients with complex valve disease a chance at longterm recovery and improved quality of life