Patient With Rare And Complex Heart Ailment Treated Successfully

A patient with a rare and complex heart condition was treated successfully at a private hospital in Kolkata. The patient, a 41-year-old businessman from Kharagpur, having the complex condition, was treated through the joint efforts of the hospital's experienced cardiothoracic surgery and cardiac anaesthesia teams.

The patient was suffering from severe aortic stenosis, a life-threatening condition where the main valve controlling blood flow from the heart becomes severely narrowed. This problem in the patient was due to a congenital defect called a bicuspid aortic valve, where the valve has only two flaps instead of the normal three.

Additionally, he had a ventricular septal defect (VSD), meaning there was a hole in the wall between the two lower chambers of the heart, resulting in abnormal blood flow. A rare and extremely complex airway problem in the patient made the treatment even more risky. Due to a long-standing severe anxiety disorder, he was on regular medication, which severely limited his ability to open his mouth.

Consequently, general anaesthesia and intubation posed a serious risk for this patient. In this situation, even a slight change in heart rate or blood pressure could be fatal.

To overcome this challenge, the doctors used a highly controlled and advanced method of awake nasal tracheal intubation. In this procedure, a tracheal tube is carefully inserted through the nose while the patient is awake and breathing, thus reducing the risk of sudden stress on the heart. The heart surgery was then successfully completed. The entire procedure took four and a half hours. The damaged valve was replaced, and the hole in the heart was closed. After the surgery, the patient recovered quickly without any complications and was discharged from the hospital in just four days.

A doctor instrumental in his treatment, Dr Kaushik Mukherjee, stated, “This patient had two serious heart conditions along with an extremely complex airway problem. In severe aortic stenosis, it is crucial to keep the heart rate and blood pressure under strict control, as even a slight fluctuation can be dangerous. Despite the complexities and anxieties involved, the patient remained calm throughout the entire procedure. Seeing him recover and return home with a smile was extremely gratifying for all of us."

The cardiac anesthesiologist added, "Due to the limited mouth opening and severe anxiety, conventional intubation was not possible. In the awake nasal intubation method, the patient can breathe on his own, significantly reducing the risk of airway failure or cardiac instability. This case once again proves that the expertise and capabilities of private hospitals in even the most complex treatments are now of international standards."