Maharashtra man undergoes fifth successful open heart surgery

Mumbai: In a medical feat of sorts, the Jaslok Hospital and Research Centre in Mumbai the fifth repeat open heart surgery on an Omani national.

The patient, Khattab Omar Rashid, a 24-year-old youth, was admitted to the hospital on 9 October and discharged on 8 November.

The announcement was made on Wednesday by the team of Jaslok Hospital, which took care of the patient.

He had previously undergone four open heart surgeries, the most recent one being about two months ago in another hospital in India. The patient was in critical condition, experiencing heart failure and an active infection, when he was brought to the hospital.

The sequence of surgeries began with the first operation addressing a birth defect of the heart (subaortic membrane removal). Subsequently, he required another operation to correct the aortic valve, which was replaced. However, a leak developed beside the valve, leading to two more surgeries in Oman. Despite a surgery in India for the infected valve, the patient continued to experience complications, ultimately being diagnosed with an ascending aortic aneurysm, a condition where the main blood vessel from the heart becomes dilated like a balloon, carrying a risk of rupture.

Managing an aortic aneurysm, particularly when it has eroded the back of the breastbone, and undergoing repeat open heart surgery is an exceedingly high-risk procedure.

These procedures pose significant risks, including excessive bleeding and potential damage to vital organs such as the brain, kidneys, and liver, especially when there is an active infection.

The patient’s treatment at Jaslok Hospital involved a ‘Heart Team Approach’, a collaborative effort comprising experienced Cardiac Surgeons, Cardiologists, Anaesthetists, Intensivists, Infection Specialists, and Technologists.

This complex surgery was successfully carried out by the team headed by Dr Suresh Joshi, Director, Cardiovascular & Thoracic Surgery and assisted by Dr Upendra Bhalerao, Consultant, Cardiovascular & Thoracic Surgery, Dr Rajashri Agasakar, Consultant, Anaesthesia, Dr Anurag Jain, Consultant Cardiac Anaesthesia and Kiran Ambre, Heart & Lung Machine Technologist The post-operative care was looked after by Dr Indraneel Raut, Additional Director, Critical Care Medicine, Dr Rahul Chabbria, Consultant Cardiology, Dr. Mala Kaneria, Consultant, Infectious Disease and Dr Samir Shah, Consultant, Haematology,

During the surgery, the aneurysm was removed along with the infected aortic heart valve, and the aortic root was replaced with an aortic homograft—a tissue graft obtained from a cadaveric donor. Procuring the homograft from the valve bank in Chennai posed logistical challenges. The use of a homograft, is a preferred option in the presence of infection, and is uncommon due to the scarcity of organ donations and valve banks.

“The fifth Repeat Open heart surgery is rare and poses extreme technical challenges. Considering the inherent risks associated with such multiple open heart surgeries and the intricate nature of the recent procedure,” said Dr Joshi.