Iraqi patient with severe valve leakage and heart damage managed at Sarvodaya.
Mr. Hasan Sabbar Hathoot, a 62 years old male from Iraq, was admitted with diagnosis of recent MI with severe valve leakage with severely damaged heart leading to interior wall Aneurysmal. Hasan was in frank heart failure NYHA IV when presented. He also had hypothyroidism and medical renal disease with moderate renal dysfunction with both renal and prerenal component. He was then stabilized medically and taken up for surgery by the CTVS team of Sarvodaya Hospital & Research Centre. His CABG & Mitral Valve Replacement was done on pump ultrafiltration was also done during surgery. Port operation Hasan was electively put on IABP while coming off Bypass. He was shifted to ICU on IABP & ventilator & high ionotropic support. Gradually on day 2, he was weaned off from ventilatory support. On 5th Day, his ionotropic support & IABP was also weaned off. Hasan’s condition was stable and was improving rapidly. He was then shifted to the patient ward after completely weaning off from Ionotropic support on Day 8. He got discharged on Day 12. On day 17 of his OPD review, it was found that he was in NYHA class II with improved heart function, normal valve function and normal renal function. Patient Hasan left for his country Iraq fully satisfied on Day 18.
Coronary Artery disease is most dreaded disease which has affected mankind and Acute Myocardial infraction which damages significant portion of heart & also damages native wall & Valve in its one of the most dreaded complication leading to heart failure & ultimately death of the patient in a very short span of time, if left untreated.
About 50% of the patients with such type of heart disease, die within 3-4 months & about 80% die within 6-8 months if left untreated. With timely & right treatment as it was done in Hasan’s case, patients are expected to live much longer and with better much better quality of life. With treatment, 80% of such patients’ lives for more than 10 years & also with much better body functional status.
Surgery in such patients is very high risk with perioperative mortality in range of 25-30% and it is also a complex surgery which require good surgical skill & expertise. The post-operative outcome is highly dependent on judicious pre, intra & post-operative management.
Management of such patients needs careful preoperative planning and medical optimization, judicious intra operative management and intensive postoperative management.
Hence, at the Sarvodaya department of CTVS headed by Dr. Sumit Narang, we are able to successfully treat patients with such complex disease and with great team effort & excellent intensive care management.
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