Mumbai woman operated upon fifth time for heart valve replacement

Mumbai: A 67-year-old woman, who had already undergone four heart surgeries in the past, has been operated upon for a record fifth time for heart valve replacement here.

Eminent cardiac surgeon Ramakanta Panda performed the operation on the woman, Pushpa Saraf, at the Asian Heart Institute recently. She had already undergone four heart surgeries in the past, but was again beset with cardiac problems.

Panda operated on her for the fifth time -- this time to replace a defective heart valve but also remove a Transcatheter Aortic Valve Implantation (TAVI) valve which had slipped inside her heart chambers and to replace the ballooned (aortic aneurysm) in her heart.

This is considered to be first time in the world that such a fifth-time redo heart surgery has been performed, Panda told media persons.

"This could be probably the first such case in the world because of the 5th time valve operation with aortic aneurysm repair and removal of the minimally invasive implanted valve done on one patient. Compared to a first time heart operation, a redo operation becomes complex as the heart and lungs get stuck to the breastbone," Panda explained.

During a redo heart surgery, there is serious risk of damaging while opening the chest, making a second time redo very complex.

"However a fifth-time redo operation along with aortic aneurysm operation is unheard of and was for the first time successfully performed at AHI," said Panda.

Another 67-year old patient from Mumbai, Satyavan Gaikwad, a diabetic, was operated on last January at AHI for five grafts, which was another rare and complicated procedure.

The AHI notched a milestone on Saturday with its 3,500th high-risk heart surgery, besides another 21,000 cardiac operations till date.

Presenting a mega study on 'beating heart redo bypass surgeries' on 411 cardiac patients, including nearly 50 percent of them diabetics, between January 2003-February 2016, AHI's senior cardiovascular thoracic surgeon Sunil Vanzara said the average number of grafted arteries used per heart patient was 3.7 against a global average of 2.3.

"This proved that the incidence and complexity of coronary artery disease in India is higher compared to the western world, and in the past four decades we have seen a four-fold increase in this. At AHI, 99.5 percent of all surgeries performed with beating heart technique," Vanzara said.

Panda reiterated that an increasing number of coronary artery bypass grafting, angioplasties and redo bypass surgeries are being performed every year in India which has a whopping 61.50 million people with coronary artery disease as per the National Interventional Council data of 2015.

AHI Medical Director Vijay DSilva said over 200,000 cardiac surgeries are performed in India of which less than one percent are redo-bypass procedures.

In 2014, as many as 248,152 angioplasties were performed -- an increase of 14.50 percent over 2013, he added.