Doctors perform double surgery on 74-year-old man

Doctors at a city hospital performed a double surgery on a 74-year-old man to correct the dilated and thin area of his heart which was bulging out after an heart attack followed by a left ventricular assist device (LVAD) implant.
LVAD is a mechanical assist device which is placed inside chest and helps the heart to pump oxygen-rich blood throughout the body. As opposed to an artificial heart, the LVAD does not replace the heart, but it helps it do its job.
Sardar Amrik Singh had suffered a heart attack and was having recurrent episodes of breathlessness on mild exertion. He was told that there were no options for his condition except a heart transplant. As a rule, heart transplants are not performed on patients beyond the age of 60 years. Also it has a major limitation of donor availability.

When the patient visited Dr T S Kler, Executive Director of Cardiac Sciences at Fortis Escorts Heart Institute, his coronary angiography revealed a 100 per cent blockage of one coronary artery identified as the cause of major heart attack.
Since the patient had a Left Ventricular Aneurysm, it posed a major challenge and the doctors had to first repair the aneurysm before LVAD was implanted.
Dr Z S Meharwal, Director & Coordinator at Department of Cardiovascular Surgery, said, "As a surgeon it was challenging for us because of the large thin walled bulging area of left ventricle which required repair before the device could be implanted. The patient was old with multi-organ dysfunction, so the concern was whether he will be able to withstand the procedure and the care post surgeries... After eliminating what could not have been performed, we opted for LVAD implant after the aneurysm was treated."

After an LVAD implant, one end hooks up to left ventricle, the chamber of the heart that pumps blood out of the lungs and into the body. The other end hooks up to the aorta, the body's main artery. A tube passes from the device through the skin. This is known as the 'drive line' and it comes out of the body through abdominal skin and connects the pump to the controller outside which is used for charging the batteries.

This is a unique achievement because it is the first ever recorded case in India of a patient of this age undergoing a procedure of such dual complexity, claimed the doctors.

The patient is making good recovery with improvement in his heart, kidney and liver function in addition to an enhanced nutrition status, they said.
"Hope was very slim... Seeing him recovering now, our confidence has further renewed," Sardar Amrik Singh's daughter said.