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Doctors are surprised how 40-yr-old Humza, clueless about his heart’s congenital anomaly most of his life, survived without early intervention

For 39 years, Hussain Ali Humza was clueless that his heart was functioning with a double-chambered right ventricle and a septal valve (a big hole in the septal wall that separates the left from the right ventricle). Humza’s survival so far into his adulthood with this condition took the doctors, who did a correctional surgery on him on November 24, by surprise.

Double-chambered ventricle is something that usually gets detected and attended to early in life. But Humza, a mechanic in an Iraqi village called Tikrit near the town Bald, had no reason to suspect his condition all his life. "Only 15 months ago, I started experiencing a discomfort, of a pinching sensation around my heart," he recalled. With little faith in the medical facilities in his country, he chose to come to Pune, where he had relatives living.

Rao Nursing Home (left), where the patient Hussain Ali Humza (right), was operated upon by the city doctors. Humza recoveredRao Nursing Home (left), where the patient Hussain Ali Humza (right), was operated upon by the city doctors. Humza recovered

The diagnosis threw up a startling revelation. "Due to the septal defect, muscles on the right side of his heart had become hard and thick. This reduced the pumping ability of his heart and even worse, the oxygenated and deoxygenated blood was getting mixed," explained Dr Manoj Durairaj, Director of Cardiac Surgery, Ruby Hall Clinic, who performed the surgery along with Dr N P Rao, the owner of Rao Nursing Home located on Pune-Satara Road, where the procedure was done.

Humza’s situation was complicated further by his obesity at 120 kg and by the fact that he was a chain smoker running through three packets in a day. "His smoking had built up his lung pressure, putting immense load on his right ventricle. I was surprised this man was still surviving," Dr Durairaj noted.

DR N P RAO, HUMZA’S SURGEONPost-operative care too was critical as we were not sure about his survival
DR N P RAO, HUMZA’S SURGEON

Double-chambered right ventricle occurs when the ventricle is divided into two parts by anomalous muscle bundles. The condition is so rare in adults that once Humza’s diagnosis was done, he was referred to an independent paediatric cardiologist. "It is nature’s way of protecting the heart that while he had a septal defect, it was balanced with a double-chambered ventricle, which worked as a blockage. I have seen around 40 children with this condition in my 20 years of work, but this is the first time, I encountered the defect in an adult," said Dr Col (Retd) Prabhat Kumar, a consulting pediatric cardiologist who conducted the echo and cardiac catheterisation on Humza.

The surgery was done coring out these muscles to unify the ventricle, which was a fine balancing act, as coring out too few muscles could leave a blockage and coring too many could render the heart muscles powerless.

"Post-operative care too was critical as we were not sure about his survival. He was kept on ventilator for almost eight days after the surgery," Dr Rao informed. To his doctors’ delight, Humza recovered and was discharged on Friday. He has lost weight and has even promised to quit smoking, and is now waiting to get back home.

Source
Times of India
21 Dec 2013,
by - Mayuri Phadnis

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