A team of 12 doctors and paramedics undertook a nine-hour-long surgery to treat a 35-year-old man whose metallic stent had migrated from the liver to the heart causing rupture in the aortic sinus, a leading private hospital in Delhi said today .
According to medical literature, the cause of rupture (migration of a stent to the heart) has not been previously recorded, it claimed.
During the surgery, his heart was stopped using a very advanced technique and the metallic stent was cut and trimmed, his aortic rupture was closed and his right sided heart valve was repaired, it said, adding that the entire surgery took almost nine hours with a team of 12 doctors and paramedics.
Doctors at the Fortis Escorts Heart Institute operated on the male patient who had developed a large hole inside his main arterial pipe called the ‘aorta’ that was caused by a metal stent which was placed inside a vein in the liver, the statement said.
This metal stent slowly migrated from the liver through the vein into the right side of the heart (called right atrium) and then ruptured the aorta.
The metallic stent had been placed inside his inferior vena cava (the main vessel to receive blood from the lower half of the body) as the patient had previously been diagnosed with a liver condition called the ‘Budd chiari’ syndrome.
The patient was showing severe symptoms of heart failure, deranged liver function and low platelet count. His surgery was quite challenging as the metallic stent was totally buried inside his heart’s vein.
The patient’s right side of the heart became almost like a large football due to right sided valve failure and an excessive blood flow to the right heart. This condition is called a shunt where blood flows abnormally inside the heart from one chamber to the other, the statement said.
The main challenges in this surgery were very high risk of heart rupture, uncontrolled bleeding and liver failure after surgery. In general, surgery of this nature have only 30 per cent chance of survival, it said.
Dr Ritwik Raj Bhuyan, Director, Cardiothoracic Vascular Surgery, Fortis Escorts Heart Institute said, “The patient had visited several hospitals for treatment. However, he had been denied the same as this was a very complicated case. He came to us with the complaints of uneasiness, breathlessness, and chest pain.
“We investigated and found that right chamber of the heart was ruptured. We operated and after two weeks he was discharged and had resumed his normal activities. According to published medical literature, such an incident has not previously occurred.”
As the patient had deranged liver and heart function, he will need cardiac rehabilitation for at least three months and should avoid alcohol, smoking and drink moderate amount of fluid, the doctor added.
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