Lifesaving surgery performed on 83 year old with heart rupture

New Delhi: Heart diseases claim a significant number of lives in India across a wide range of demographic profiles. Men are known to be at a higher risk in comparison to women and with age and pre-existing co-morbidities, complexities go up. But, a slowly weakening heart is much easily treatable in comparison to a massive heart attack, which leads to internal bleeding and may cause permanent damage. Such was the case of 83-year-old N.S. Mehra, a retired businessman from DELHI, who underwent complex open heart surgery which saved his life. A rare medical feat as only very few rupture cases is successfully treated within stipulated timelines in India and globally.

Mr. N.S Mehra suffered a massive heart attack due to instantaneous blockage leading to a hole in the wall of the left ventricle. At the time of attack, the patient’s heart was beating at double the normal rate @ 140/min. Patient’s ECG and ECHO revealed that the heart attack had led to a severe rupture in the left ventricle wall of the heart. This resulted in internal bleeding causing accumulation of blood in the pericardium (the membrane enclosing the heart).

The patient was brought Max Super Speciality Hospital, Vaishali on a ventilator to be treated by Dr Gaurav Mahajan, Principal Consultant and Head – CTVS. He was scheduled for immediate surgery (From emergency to OT in a record time of 25 minutes). Later he was put on a heart-lung machine and his heart was arrested for almost 2 hours.

The 6-hour high-risk cardiac surgery was successfully carried out on 1st February 2019. The rupture was repaired through a double suturing, also known as ‘double-layered repair’ using a small part from synthetic materials or PTFE (Polytetrafluoroethylene) and the pericardium (the outer the membrane enclosing the heart).

Mr Mehra was later discharged a week of undergoing this life-saving surgery and is currently doing well. He has gone back to doing his regular chores and even attended his grand daughter’s wedding 20 days after the surgery.

Talking about the case, Dr Gaurav Mahajan, Principal Consultant and Head – CTVS, Max Super Speciality Hospital, Vaishali says, “In the majority of heart rupture cases, the patients are unable to reach the hospital in a treatable condition as the condition deteriorates at a life-threatening rate. In this case, owing to effective emergency response, timely and accurate diagnosis and immediacy of surgery, we were able to save Mr Mehra.”

Dr Mahajan added: “Being an aged individual with a history of hypertension, he suffered a sudden heart attack which ruptured the wall of the left ventricle of the heart leading to internal bleeding. The ECHO confirmed our diagnosis and without losing a single second, a highly complex open heart surgery was performed by a team of a multidisciplinary team of doctors including cardiac surgeons, physicians, anesthetists, nurses and perfusionists. We repaired the rupture through a double suturing, also known as ‘double-layered repair’ using synthetic materials i.e. PTFE (Polytetrafluoroethylene) and the pericardium. After a week of post-surgery care and observation, Mr Mehra was discharged with a positive prognosis.”