02 July 2012
Man Kept Alive On Ventricular Assist Device As Doctors Repair Valves
NewDelhi:For four days, Ravinder Kumar (52) lived without a heart, literally. In order to repair a serious defect in his valves, doctors had to replace the organ – which was too weak to even pump blood – with an artificial device.
Left Ventricular Assist Device (LVAD), a machine which mimics the heart’s functions, offers a ray of hope to thousands of patients whose hearts are too weak to survive a life–saving surgery and those waiting for heart transplant, say doctors.
In most western countries like the US, research and study is on to develop the miniature version of the machine into a mechanical circulatory support device which can permanently replace the natural heart.
"The heart and lung machine, which is commonly used to support organs during cardiac surgeries, also works on the same principle but it can only function for four to six hours. Also, prolonged use can cause severe side–effects which may eventually lead to death due to heavy bleeding.
On the other hand, LVADs can pump blood for two weeks or even more thus increasing the window period for doctors to correct the heart defect," said Dr Sujoy Shad, senior consultant cardiac surgeon at Sir Ganga Ram Hospital who conducted the successful surgery.
He said that Kumar was brought to the hospital in a state of shock because of severe choking in the main valve of his heart and leakage in another valve.
His heart had lost its pumping power.
"Despite powerful medications, his blood pressure hovered at 70–80 mm hg. His heart was working at only 15% of its normal capacity. He may not have survived for more than a week if it wasn’t for the surgery.
The leaking valve was repaired and the aortic valve which had constricted to the size of a pinhole causing restriction in flow of blood was replaced during the operation," said Dr Sanjiv Dhawan, senior consultant cardiologist at the hospital.
Doctors said that in Kumar’s case LVAD was used for five days to perform the heart’s functions like ensuring optimum supply of blood to other organs.
"The patient can breathe now; he is also able to walk and talk. He will be discharged soon," said Dr D S Rana, chairman, Sir Ganga Ram Hospital .
He added that not all heart failure patients need to undergo a transplant as doctors can repair the damage with the help of new–age techniques.
Kumar’s son Vikrant Kumar, who was ecstatic with the outcome of the surgery, said, "We tried to sell the house to pay for the operation but our relatives and friends arranged the money for us," he said.
Dr Ashok Seth, chairman of cardiovascular sciences at Fortis Escorts Heart Institute was among the first doctors to use LVAD for treating heart failure patients in India.
He implanted the device in an 82–year–old patient suffering from blockage in three arteries in 2007. Doctors at AIIMS have also conducted similar procedures.
"We have operated seven patients using LVAD. One patient recently underwent a transplant also," said Dr A K Bisoi, senior cardiac surgeon.