Doctors at KIMSHEALTH, a world-class multispecialty hospital here, performed last week a unique Heart Valve Preserving Surgery (David Procedure) on a 29-year-old man who was brought to the hospital with history of anxiety and uneasiness.
KIMSHEALTH is one of the few centres in India and the only centre in South Kerala performing the valve sparing surgery, which would benefit the patient by way of early recovery and longer life expectancy.
On being brought to the hospital, the patient, a script writer and short film director, was initially examined by Dr Susha John, who diagnosed him with severe hypertension with blood pressure at 250/180mms.
He was then referred to Dr Meera R, as he had a history of being hypertensive for the last three years. Echo was done for further evaluation, which showed a dilated aortic root and he was advised admission for further evaluation.
A CT aortogram confirmed an aortic root aneurysm. An aorticroot aneurysm is a dilatation that occurs at the origin of aorta. Aortic root dilation (AoD) would lead to increased risk of aortic complications such as dissection, rupture, and valve failure.
Due to the high risk of rupture in view of co-existent hypertension, he was admitted under Dr Sujit, Cardiac Surgeon and was advised an early surgery.
The options for surgery were classical valve replacement or to go for a unique valve sparing surgery. Considering the age of the patient, valve sparing method was advised to the patient for long term results and to lead a normal life.
The valve-sparing method is a surgical treatment in which the aneurysm is repaired while the patient’s own valve is preserved. This method helps to avoid anticoagulants that would reduce the incidence of stroke and major bleeding and frequent blood tests that are required.
The use of anticoagulants is a reason for patient mortality in most valve replacement surgeries and all these complications could be minimised through a valve sparing surgery.
The patient was taken for the valve sparing surgery by Dr Sujit with the aid of a heart-lung machine. After arresting the heart, the aorta or the major blood vessel was opened and the dilated aortic root was excised.
Preserving the aortic valve of the patient it was sewn into the new graft used to replace the aortic root. The coronary arteries (main blood vessels of heart) were also sewn onto the graft.
The patient was extubated the same day and was shifted to a room on the third day post-surgery and made an uneventful recovery.
Dr Sujit said that the patient’s blood pressure after surgery is in the normal range with medications and an Echo that was taken after the surgery showed a normally functioning aortic valve.
The patient was discharged on the fifth day after the surgery.
Dr Subash – Cardiac Anesthetist, Dr Vijay – Associate Cardiac Surgeon were also part of this surgery.
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