SUCCESS STORIES IN HIGH RISK SITUATIONS IN CARDIAC SURGERY
1. 52yrs Male was admitted with Severe Calcific aortic stenosis with LVF. His heart function on 2D Echo was 25% with features of pulmonary oedema. He was admitted stabilized and decongested. His angiography revealed a diagonal branch having 50% stenosis. After 2 weeks of stabilization he was taken up high risk aortic valve replacement. His Echo followed by CT scan showed grossly dilated aortic root of (5.5 cm). It was debated whether to change only valve or replace the aortic root with valved conduit. Since he was very sick it was decided to go ahead prepared for root replacement but if aortic walls were preserved only aortic valve will be changed. Under standard cardiopulmonary bypass and cardioplegic arrest aortic valve are changed with 21mm St. Jude valve. Post operatively he behaved well and remained stable and was discharged on 8th POD. In the follow up his heart function has returned back to normal.
2. A 59yrs old male was admitted with dilated ischemic cardiomyopathy with EF of 20% and severe Mitral Regurgitation, acute LVF and NIDDM. With renal dysfunction. He was put on IABP pre – operatively and CAG revealed diffuse Triple Vessel Disease. In spite of IABP and Inotropic support patient remained in LVF and blood counts were high. He was on heavy antibiotic. It was decided to intervene surgically and CABG with MVR was done. Three vein grafts were put and mitral valve changed with 27mm St. Jude valve. Post operatively patient improved fast and extubated 3rd POD and IABP removed 5th POD and was discharge on 13th day. His follow up showed improvement in his heart function to 38%.
3. A 4yrs old female presented to us as blue baby since birth and on investigation was found to be having classical pentalogy of fallot but with very small pulmonary arteries and failure to grow. At 4yrs her weight was 8kgs only. Both the pulmonary arteries were small and made her high risk for surgery but was again treated and operated and her hole in heart was cleared with Dacron patch and pulmonary arteries enlarged with a pericardium patch across the outflow track of right ventricle. ASD was closed and post -op she was electively ventilated for 72hrs and then extubated recovered and discharged well after 8 days.
4. A 59yrs old male was brought to hospital with acute anterolateral MI with thrombus in LAD Ostea, acute pulmonary oedema and EF of 40%. He was immediately taken up for angiography which showed left main stenosis with critical Triple Vessel Disease. He was out on IABP as he was not maintaining pressure and was having arrhythmias. With in 3hrs of reaching hospital he was taken into Operation Room for CABG and 4 grafts were put in on him on beating heart. He improved and remained stable in post operative period was extubated on 1st POD on discharged on 8th day on good condition. Post-op Echo shows normal heart function.
5. MaxHospital, Mohali helps save life of a critically ill Poor Patient with LifeSaving Heart Surgery