Maharashtra youth with major heart defect saved after marathon 16-hour surgery

By Quaid Najmi

Mumbai, Feb 19 (IANS) A 20-year youth from Jalgaon, who suffered from a major and extremely rare congenital heart defect, was saved after a record 16-hour plus surgery at the Asian Heart Institute (AHI) by a team led by a doctor who had performed heart bypass surgery on then prime minister Manmohan Singh a decade ago.

The patient, Rajendra Deshmukh (name changed on family's request) was born with two aortic valves instead of normal three - a rarity that can occur in less than one per cent of human beings - and underwent a total of four critical high-risk operations by eminent cardiologist and AHI Vice-Chairman, Dr. Ramakanta Panda.

He underwent the procedures using the Manouguian technique to first enlarge the aortic root followed by three separate operations through the Redo-Bentall technique for replacing a faulty heart valve, repairing the aortic aneurysm repair and re-implanting the coronary artery.

These four surgeries enabled fix Deshmukh's extremely narrow heart valve and a ballooned-out aorta since he suffered from the congenital heart valve disease and had his first valve replacement at the age of 10.

Hailing from a poor family - his father is a school teacher - two years back, Deshmukh, then a junior college student, again suffered from severe heart problems which left him breathless and utterly exhausted even after minimal physical activity, like walking in the home.

"I could not enjoy a normal childhood. After the first valve replacement surgery, my condition improved, but the problems returned two years ago," said Deshmukh, months after the multiple surgeries from which he recovered well and is now convalescing in his home but performing his normal routine.

"His heart valve was very small, only 17 mm, though ideally for his age and body size, it should be at least 21 mm, so enlarging the size of the heart valve was crucial to save him as it affected his heart functioning and the ballooning out of the aorta posed additional risk of sudden rupture," Panda explained to IANS.

Panda termed it as the longest-ever operation he had ever performed, and one of the rarest and riskiest procedures in his medical career of more than 20,000 heart surgeries, besides (in Deshmukh's case) involving a combination of some of the most complex surgeries done simultaneously on any patient.

The Manouguian technique itself was a huge challenge for the medical team. In involved increasing his narrowed aortic heart valve by an additional 6 mm valve area to enlarge it and fit in a bigger 23-mm valve (against the earlier 17 mm Deshmukh was born with) though there was hardly space left for it, besides the second time surgery to replace the faulty heart valve, he added.

The patient has recovered well and was discharged in the third week of November. He is now leading a normal healthy and active life, said Panda.

Around a 100 days post-surgery, he confidently added that Deshmukh is not likely to require any such operation in the future.

It is the general practice in such complex cases to allow adequate time to pass before bringing them into the public domain.

(Quaid Najmi can be contacted at q.najmi@ians.in)