Young woman has open heart surgery, C-section

When K. Pallavi was seven months pregnant doctors back in Tumkur diagnosed her with a heart problem. The 23-year-old, married to Pandu Kumar of Kunikenahalli near Turvekere in Tumkur district, was then told her baby was at risk.

When her symptoms worsened — she was now eight-and-a-half months pregnant — she and Mr. Pandu Kumar went to the Sri Jayadeva Institute of Cardiovascular Sciences saying she had difficulty in breathing. Little did they expect that not only would her heart be fixed but that she would also give birth to her baby, all at one go.

Seeing the young woman’s condition, Jayadeva doctors immediately prepared her for an open heart surgery. Once that was done, she was delivered of a healthy baby through Caesarean section on the same table last fortnight.

Even as cardiac surgeon Seetharam Bhat performed the heart surgery, his wife Nirmala Bhat, a gynaecologist with private practice, pitched in for the C-section delivery, as Jayadeva has no in-house gynaecologists and given the emergent situation. In fact, this was the first C-section ever in this hospital that specialises in cardiac problems.

Complex case

Doctors diagnosed Ms. Pallavi’s condition to be rheumatic heart disease. She also had critical narrowing of the heart valve and it was severely deformed with fibrosis and calcification, a condition known as mitral stenosis. She was prepared for an open heart surgery and valve replacement after a balloon valvuloplasty failed.

Jayadeva director C.N. Manjunath explained that the patient presented a very rare complex clinical situation. “In such a situation, although the priority is to save both the mother and baby, medical termination of pregnancy is recommended as mother’s life is at a higher risk. Pregnant women with symptomatic heart disease have very high maternal mortality, miscarriages and foetal deaths.

“In this kind of situation, there is a clinical dilemma whether to first do an open heart surgery or Caesarean surgery. Open heart surgery on pregnant women will increase the risk of intrauterine death of the foetus and also carries the risk of bleeding as blood thinning medicine (Heparin) is mandatory,” he said.

“During surgery, the baby’s heartbeat was monitored continuously. With new techniques and methodologies, the foetus was kept alive till the valve replacement surgery was conducted. Soon after the completion of heart surgery, the baby was delivered. The mother and baby, who are doing fine, have been discharged,” Dr. Manjunath added.

The grateful parents named the baby Jayashree, in honour of the hospital’s name.