Mumbai : In a medical first, a 24-year-old man from Oman underwent a successful fifth repeat open heart surgery.
On October 9, Khattab Omar Rashid, a patient with heart failure and an ongoing infection, was brought to Jaslok Hospital and Research Centre in Mumbai.
He had already had four open heart surgeries, the most recent one being in a different Indian hospital roughly two months earlier.
The initial procedure (subaortic membrane excision) treated a congenital cardiac problem. He then needed to have the aortic valve replaced in order to rectify the condition.
But next to the valve, a leak appeared, necessitating two more procedures in Oman. The patient had an ascending aortic aneurysm, which is a condition where the main blood vessel from the heart becomes distended like a balloon and carries a risk of rupture, after difficulties persisted after an infection-treated valve was surgically removed in India.
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, said the doctors at Jaslok.
The procedure poses 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, they added.
“5th 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. Suresh Joshi, Director Cardiovascular & Thoracic Surgery at Jaslok, in a statement.
The infected aortic heart valve and the aneurysm were removed during the procedure, and an aortic homograft—a tissue graft taken from a Chennai cadaveric donor—replaced the aortic root.
Due to the lack of organ donors and valve banks, the use of a homograft is not widespread but is the chosen course of action when infection is present.
“This is the first time a homograft has been successfully used in a repeat heart surgery in Maharashtra, and possibly in all of India,” said Dr. Upendra Bhalerao, Cardiovascular & Thoracic Surgery at Jaslok, who also assisted with the procedure.
Rashid is doing well and was discharged on November 8, the doctors said.
