Doctors at Gleneagles Global Health City (GGHC) hospital here have replaced an infected heart valve of a person with a homograft aortic valve through a complex procedure, which necessitated the reduction of his body temperature to 18 degrees Celsius to pause the blood flow in the body for around eight minutes.
The patient, a 39-year-old teacher from Oman, was having recurrent infection of the aortic valve, reportedly due to an unexplained fever and a dental procedure, a statement by the hospital said. Despite undergoing three heart surgeries earlier, infection recurred around the replaced mechanical valve.
To add to the complication, the infection resulted in the patient developing a pseudo aneurysm of the aorta, which referred to the ballooning of the aorta. After complications worsened, he was referred to GGHC.
Anto Sahayaraj, senior consultant, cardiothoracic and vascular surgery, GGHC, said the situation demanded a complex and careful treatment strategy. “The main challenge was to get to the centre of the patient’s heart in a setting of a densely scarred chest, due to previous cardiac surgeries and with a pseudoaneurysm ready to burst, sitting right under the breast bone,” he said.
He said the doctors decided to go for a homograft aortic valve instead of the conventional mechanical or bioprosthetic valve as the possibility of reinfection was less. Homograft aortic valves are human valves taken from the harvested heart of brain-dead persons and cryogenically preserved at around -70 degrees celsius in liquid nitrogen.
“The patient had suffered a stroke a few months ago. As we wanted to take all possible precautions, we continued the blood flow to the brain,” Dr. Sahayaraj said.
During the procedure, the pseudo aortic aneurysm was controlled first, following which the infected mechanical valve was removed, infection surrounding it was cleared and the homograft aortic valve was implanted. Susan George, senior consultant, cardiology, GGHC, said the surgery was extremely challenging and utmost care was taken to ensure that the patient was safe from any further risk of infection.
Subramanian Swaminathan, director, Infectious Diseases, GGHC, said that the complex procedure was necessary as the patient was not responding to conventional treatment.
The patient, who finished the procedure in the first week of September, flew back home after two weeks of post-operative care, the statement said. Alok Khullar, CEO, GGHC, lauded the team.