Rare cardiac surgery performed

 Dr V Nandakumar, chief cardiac surgeon at the Kovai Medical Centre in Coimbatore has performed a rare cardiac surgery on Ramaswamy, a chronic renal patient.

 

"I wanted to make sure that Ramaswamy of Tirupur is perfectly normal before disclosing it to the outside world. Now, more than a month has passed after the surgery and the patient is perfectly normal," Dr Nandakumar, who had worked as a professor at the Kozhikode Medical College, told Express. "After browsing the net, I could not find a similar case anywhere in the world," Dr Nandakumar, who had also served in Melbourne for three-and-a-half years, said.

 

Ramaswamy, 58, was brought to the Kovai Medical Centre with excruciating back pain. He had undergone kidney transplant 25 years ago and was keeping well all these years.

Investigations, including 64 slice CT Angiogram, revealed a long tear in the aorta (aortic dissection), starting from the aortic valve, causing severe valve leak and reaching to the base of the artery supplying blood to the right arm and the brain (innominate artery).

 

The tear in the aorta had further reached the outside the heart which made it more serious. In addition, three coronary arteries had major blocks and the functioning of the kidney had also deteriorated.

An emergency surgery was planned. Dr V Nandakumar, along with a team of doctors, successfully performed a 10hour surgery to replace the damaged aortic valve and the aorta with an artificial valve and tube graft and triple coronary bypass grafts. The body temperature of the patient was kept at 18 degrees Celsius.

 

Since the tear in the aorta was extending to the root of the artery supplying blood to the brain, the whole body circulation had to be completely stopped for nearly 45 minutes. During this period of total circulatory arrest, there was no effective circulation throughout the body, and tissue metabolism was maintained at very low levels by maintaining low body temperature. Circulation was reestablished at the end of the procedure and the heart began to beat normally. Ramaswamy recovered fully and was discharged after three weeks.