India’s 1st heart explantation surgery conducted in Noida hospital
In an extremely rare surgery, doctors at Fortis Hospital here have removed an artificial heart implanted on a 56-year-old patient from Iraq — the first in India, the hospital said on Tuesday.
The left ventricular assist device (LVAD) is recommended as a last resort on patients diagnosed with end-stage heart failure. The machine is designed to mimic the functions of a biological heart and is an alternative for patients who need a heart transplant. Since 2014, about 130 patients in India have opted for the device.
“But there are only a few cases of artificial heart explantation reported worldwide. This is the first such case in India and provides hope for terminally sick heart patients,” Dr Ajay Kaul, Chairman – Fortis Heart and Vascular Institute, Noida, told Media.
Hani Jawad Mohammed was first brought to the hospital with terminal heart failure in 2018. He was extremely breathless and could not do routine activities like taking a bath without help.
Since no surgical procedure was possible, he was put on a heart transplant list. While waiting for the donor his heart started deteriorating and the doctors decided to implant an artificial heart on him.
A follow up every six months showed his heart to be functioning well. But after one and a half years he developed a driveline infection — the most common type of LVAD-associated infection.
“We tried to treat it and during a routine checkup we found that his heart had recovered completely,” said Kaul.
“The fact that his heart had recovered completely was uncommon. However, since it had, we reduced the speed of the pump. His heart was still functioning at optimum capacity, but we kept the pump running to be on the safe side,” he added.
The doctors asked Mohammed to come again after six months for a follow up. They observed him over the next one year to be sure that the heart is functioning well without the support of the pump.
“It was decided after due consultation with the patient that the artificial heart would be explanted. The explantation procedure is a novel surgical procedure which was conducted for the first time in India successfully and the patient was discharged within 5 days and is doing very well,” Kaul said.
For patients with heart failure, Kaul said doctors generally use a heart lung machine that works for 2-3 days. Another is extracorporeal membrane oxygenation (Ecmo), which works for around two weeks, then there is a centrifugal pump which works for a month.
“So there are many patients, who are supported on these three systems and after a rest of 20-30 days, they recover. In all these, proper rest given to the heart can help patients recover completely once,” Kaul said.
