Kolkata :
Doctors at the B R Singh Hospital in Kolkata have successfully replaced Mitral valves of two patients without stopping their hearts. Cardiologists at the hospital under Eastern Railway, have claimed that such surgeries have been performed in the eastern part of the country for the first time. According to them, keeping the heart beating during such a surgery reduces chances of post-operative complications.
“The first surgery was conducted a few days ago on a 51-year-old female patient suffering from severe Stenotic Rheumatic Mitral Heart Disease. After that a similar surgery was conducted on a 52-year-old male patient. Such surgeries are normally performed after the heart is stopped by using a special solution called Cardioplegia. After the surgery, the surgeon has to restart the heart and reintroduce blood into the heart muscles. This is known as Reperfusion and can cause impairment of heart function,” said cardiac specialist Alok Mazumdar who along with Himanshu K Dasmahapatra of the Advanced Cardiac Care Centre was part of the team that performed the surgery.
The Mitral valve is located in the left or more important half of the heart. This valve separates the upper and lower chambers on the left side and is very critical for proper functioning of the organ. “Reperfusion injury can cause complications such as irregular heart rhythms (Arrhythmias) and pump dysfunction. Reperfusion injury is especially a concern in high risk patients, such as elderly people who had previous heart operations and those with complex health problems. Reperfusion can be avoided if the heart is kept beating during surgery. Beating heart surgery leads to better preservation of heart function, better survival rate, especially in high risk patients. There is less chance for developing any heart rhythm, kidney or liver complications and most importantly, reduce the risk of neurological complications including stroke and memory problems. Hospital stay is also reduced due to quicker postoperative recovery,” Mazumdar added.
The surgeries at B R Singh Hospital were performed with the aid of Heart-Lung Machines. The hearts of the two patients were continuously perfused with Oxygenated blood and they remained in a state of slow and empty beating to allow the Mitral valves to be removed and replaced by metallic ones.
“No Cardioplegia was used and the risk of developing any major complications after valve surgery in this unique way is significantly lower than performing surgery in a stopped heart. There are no records of such a surgery being performed before this in the eastern part of the country. A handful of such surgeries may have been performed elsewhere in the country,” the doctor said.
According to noted heart surgeon Kunal Sarkar, this was a commendable effort. “Such surgeries are rare as a lot of precision and expertise is required. Doctors normally go in for such surgeries only if the patients suffer from certain complications. Normally, the heart is stopped during valve replacement as the risks involved during the surgery itself are less,” he said.
source: http://www.timesofindia.indiatimes.com / The Times of India / Home> City> Kolkata / by Jayanta Gupta, TNN / July 21st, 2014