A rare cardiac surgery was performed at Wockhardt Heart Hospital, Surat by a team of doctors headed by Dr Jayarama Pai T. successfully. The surgery is first of its kind because of Aneurysm of Aorta Mitral Fibrous Zone with Aortic Valve Replacement and with Coronary Bypass Grafting Surgery, and to come out successfully from flows of death. This unique triple surgery was performed and this kind of surgery has not been reported in any of the world literature.

Sheshnath Singh, 40 years old male was suffering from recurrent severe right sided chest pain radiating to right shoulder for last two months. For these problems he has taken multiple consultations at Surat, Delhi, Bombay & Lucknow with no proper diagnosis and treatment plan. Suddenly, he developed severe anterior chest pain, breathlessness with perspiration on February 5, 2010 in early morning 4:30 am. He immediately rushed to Adventist Wockhardt Hospital and he was admitted in the
Intensive Care unit on 5th Feb at 4:45 am. He underwent MR Angio which showed aneurysm of Sinus of valsalva-Non Coronary cusp. He had heart attack for which Coronary Angiography was done by Dr Asif Raheem, which showed- blocked coronary artery (circumflex) by a dislodged clot from the aneurysm. Echo showed low ventricular function with severe aortic valve stenosis and regurgitation.

Patient with unstable angina with recent heart attack taken for this high risk urgent operation. He underwent surgery on February 9, 2010 by Dr Jayarama Pai- senior consultant cardio thoracic & Vascular Surgeon. He did aneurysmal repair using patch, Aortic valve replacement using mechanical valve & CABG to bypass blocked heart blood vessel.

The surgery is rare by nature because of the following complications. Heart may not recover well when you operate on a three days old heart attack patient. During the process of surgery the chances of heart muscle getting ruptured is very high. Aneurysm surgery can produce extensive bleeding and clot dislodgement causing stroke and repetition of heart attack is very high. Placing the artificial valve at the aneurysm site is technically difficult. Any center which is not capable of tackling the above complications would not be able to conduct such kind of surgery and the experience of a surgeon plays a major role.

It is an extremely rare case because usually the aneurysm occurs any other area apart from the aorta Mitral Fibrous Zone and also the clot from the aneurysm getting dislodged into the coronary artery is very rare. Over and above all these three surgical problems occurring in a single patient is very very rare.

“This has been one of the most technically challenging and creative operative procedure for us. The Patient recovered well and able to move out from ICU on 3rd day. He has been discharged on 9th post operative day. We are planning to present this case in the international journals and conferences.” says Dr Jayarama Pai.- Cardiac Suergon, Wockhardt Hospitals, Surat.

What Wockhardt has created here is a medical example of unique cardiac surgery. Operations like this may open up the possibilities for patients who have given up hope. Since this is a rare surgical experience, it may serve as an example to other medical fraternity who may come across similar cases. Such kind of surgery would normally cost around seven to eight lakh in metro cities. We have been able to offer the same quality care at almost one third of the cost,” said Hemant Bhatnagar – Center head. We also thank the cardiologist Dr Asif Raheem, Alok Ranjan and the team of Surgical and Anaesthetists for their whole hearted support in Conducting this complex surgery successfully and given a new dimension to the world of Cardiac Surgery. Once the surgery is published, we are sure that the Wockahrdt Hospital, Surat would find a comfortable position in the world map of cardiac surgery.