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| 21 March, 2018

UAE surgeons perform one of the world's rarest heart surgeries

22-year-old man's heart had to be stopped for 70 minutes on operation table.

Image used for illustrative purpose.
Professor Jan Pirk (L), doctor Marian Urban and suture nurse Diana Vapenkova (R) perform a heart surgery at the Institute of Clinical and Experimental Medicine (IKEM) in Prague, June 28, 2012.

Image used for illustrative purpose. Professor Jan Pirk (L), doctor Marian Urban and suture nurse Diana Vapenkova (R) perform a heart surgery at the Institute of Clinical and Experimental Medicine (IKEM) in Prague, June 28, 2012.

REUTERS/Petr Josek

Doctors in Abu Dhabi have conducted one of the world's rarest heart surgeries, which has only been performed on less than 20 people worldwide.

The high-risk, four-hour long quadruple valve replacement surgery, in which the patient's heart valves were replaced with tissue valves, meant that the 22-year-old man's heart had to be stopped for 70 minutes on the operation table.

Surgeons replaced all four heart valves in the patient, who was suffering from acute infective endocarditis, that was caused by an infected tooth.

Dr Rakesh Suri, CEO of Cleveland Clinic Abu Dhabi, told Khaleej Times that the patient was literally hours away from his death.

"When I went to see the patient before the surgery, I was so struck by the fact that he was so near to death and really had no options - that it became a moral obligation to get him to the operating table as quickly as possible."

Dr Suri pointed out that infections in native heart valves are extraordinarily rare. Moreover, he stressed that the patient arrived at a very late and critical stage.

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"All the four valves were badly infected, destroyed, and his heart was incapable of supporting the organs in the body, because it wasn't able to generate enough forward pumping of blood to support life."

Dr Suri said that this was the first time the operation took place in the UAE.

"In terms of medical literature worldwide, this is extraordinarily rare."

He explained that infective endocarditis is caused when bacteria enters a patient's blood stream via a remote infection and attaches to the heart valves.

While rare, the infection can be caused by something as simple as having teeth cleaned or by a tooth abscess. The patient, who became sick in December last year after having an infected tooth removed, had his condition quickly deteriorate.

However, doctors in Dubai initially diagnosed the man with pneumonia.

Meanwhile, the patient's infection rapidly spread throughout his body, attaching itself to all four heart valves and severely damaging them.

In January, he was transferred to Cleveland Clinic Abu Dhabi, where a multidisciplinary team proceeded with the surgery, despite the low survival rate.

"We studied his condition among a multidisciplinary team and told him that this was a high-risk operation," said Dr Gurjyot Bajwa, staff physician in cardiac surgery in the hospital's Heart and Vascular Institute.

"However, without it, he would not have survived."

During the open-heart surgery, the patient was placed on a heart-lung bypass machine and his heart was stopped for 70 minutes.

"We began with the valves on the left side of the heart: The aortic and mitral valves. We quickly removed them and replaced them with the tissue valves."

Doctors then replaced the pulmonary valve, on the right side of the heart, and then moved on to the final valve, the tricuspid.

"It was a time critical, efficiently run operation - and that was the key to getting him off the table alive."

Dr Suri said that despite the risky operation, the patient has recovered quickly, and once his heart healed, it was his other organ systems and strength that he required recovery from.

"To see him smiling for the first time, was profoundly impactful."

"By the time he was ready to leave, we were all in tears and imagining the life he would lead - a life he almost didn't have the chance of participating in," added the CEO.

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