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A rare and high-risk heart valve replacement surgery unique in the state of Tamil Nadu performed by SIMS Hospital, Vadapalani, Chennai Chennai, Tamil Nadu, India (NewsView) The heart surgery team led by the Dr VV Bashi, The Director and Senior Consultant of the Institute of Cardiac and Aortic Disorders (ICAD) at SIMS Hospital in Vadapalani performed an extremely difficult surgery of opening the heart for the fifth time and replacing the bioprosthetic valve (tissue) degenerate of a sixty-year-old patient. old woman, adding more healthy years to her life. Speaking about the first rare and complex surgery of its kind, Dr VV Bashi said, “With the continued advancements in heart surgeries, more and more reoperative heart surgeries are also being performed to improve the life expectancy of heart patients. However, a fifth heart valve replacement remains a rare and extremely risky surgery in my 40-year career. This requires a great deal of experience and precision, as it is an extremely complicated procedure with risks of death and heart failure. Since the patient has already had four heart surgeries in the past, the internal scar tissue between the chest structure makes it quite difficult to reenter the chest and perform the surgery without damaging parts of the heart like the chambers of the heart, coronary arteries, aorta, etc. Further removing the existing tissue valve from the heart and replacing it with a new valve without damaging vital structures requires careful planning and meticulous execution. Having performed this type of surgery safely and successfully, it is gratifying to say the least. ” Sharing the patient’s story and the line of treatment, Dr Mohammed Idhrees, consultant in cardiothoracic and vascular surgery, said: old woman suffered from rheumatic heart disease. She underwent two mitral valve repairs in the early 1990s. She underwent a third surgery in 2008 in which a mechanical valve was implanted. Unfortunately, less than a year in 2009, her mechanical valve malfunctioned because she was not strict on her medication protocol. She underwent a 4th mitral valve surgery, where her mechanical valve was replaced with a tissue valve, which gave her a lease of 12 more years. However, 12 years later (in 2021), his tissue valve degenerated, requiring replacement. Now we had to do an open heart operation for the fifth time to remove it and replace it with a new biofabric valve. Additionally, the decision to choose between mechanical or tissue valve for patients undergoing surgical heart valve replacement comes with many complexities that involve the synthesis of clinical factors such as risk of bleeding, likelihood of reoperation, and patient preference. patient. Further, Dr VV Bashi added: “Since this patient was a 60 year old female with a history of four cardiac surgeries, the complexities of the fifth surgery, including mortality and morbidity, did not have increased that exponentially. We examined his condition after conducting several laboratory investigations and diagnoses. The results revealed that she had degeneration of the bioprosthetic valve, which caused her severe shortness of breath. If left untreated, it can prove fatal over time. Therefore, despite all the challenges, the SIMS cardiac surgery team decided to perform bioprosthetic valve surgery after ensuring the patient’s suitability. The 7 hour surgery turned out to be a success and on a postoperative examination the tests performed on her showed that her heart was functioning extremely well and she is doing well and going about her normal activities. Rheumatic heart disease is a common clinical condition in India and rare in the western world. Although valve repair is the best option, not all valves affected by rheumatic heart disease can be repaired. In scenarios where the heart valve needs to be replaced, the patient has the choice between a mechanical valve and a bioprosthetic (tissue) valve. The mechanical valve can last a lifetime, but patients must take blood thinners throughout their lives and maintain a specific range to avoid complications. Values above the range may cause bleeding, while values below may cause the mechanical valve to malfunction. On the other hand, the implantation of bioprosthetic (tissue) valves will avoid the use of anticoagulants, but these valves have a lifespan of 10 to 12 years, after which they must be replaced. Researchers around the world are looking for an ideal valve that will last a lifetime without blood thinners. Until then, these patients must be managed effectively and safely. Dr Raju Sivasamy, Vice President of SIMS Hospital, said in his assessment: “These types of complex cases are only performed in a few elite medical institutes around the world, as they require superior surgical skills and advanced technology. We are extremely delighted that ours is one of such specialist centers with a team of experienced cardiothoracic surgeons, cardiac anesthesiologists, trained nursing professionals and technicians and other support teams under the leadership of Dr VV Bashi, who could safely and successfully perform such a rare and high-risk surgery, saving the patient’s life and breathing new life into her. Additionally, during the COVID-19 pandemic, SIMS treated over 3,000 COVID patients with dedicated centers across the city and continued to perform normal heart surgeries, with all necessary precautions for the benefit of our regular patients. Image: 60-year-old woman with rheumatic heart disease undergoes successful heart valve replacement surgery performed for the 5th time by SIMS PWR PWR hospital
(This story was not edited by Devdiscourse staff and is auto-generated from a syndicated feed.)
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