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Daijiworld Media Network
27 August 2009
Mangalore, India

Dr R Harish
Zainabba Ismail, a 38 year–old female patient, had approached Yenepoya Specialty Hospital, Kodialbail here, with a history of breathlessness (NYHA grade II) for the past two years. Two years back, she had been diagnosed with a heart ailment requiring surgery, but the poor economic condition of the family prevented her from undergoing the surgery. She had delivered a child in Yenepoya Hospital four months back and at that time too, she had been advised to undergo heart surgery.

After her condition deteriorated, she approached the hospital, complaining of the swelling of her feet and abdomen region. She said that her breathlessness prevented her from lying down.

Resident cardiologist of the Hospital, Dr Paul Varghese, diagnosed her to be suffering from left Atrial Myxoma, a rare tumour of the heart, which could be potentially fatal. She was facing the eventuality of cardiac failure and needed immediate surgery to save her life. The hospital offered to conduct the surgery at a subsidized rate, considering her financial condition.

On August 17, a team of doctors led by the Chief cardiac surgeon, Dr Harish R, conducted an open heart procedure on Zainabba, to remove the tumour. It was a tricky procedure requiring careful handling of the heart as the tumour, if dislodged, could spread to other areas or could embolize and produce stroke. The tennis ball–sized tumour, with jelly–like consistency, was attached to the atrial septum and was herniating to the left ventricle through the mitral valve. It was removed in a five hour–long surgery. Complete removal was necessary and was confirmed in the theatre by Trans–esophageal echocardiography. She was treated in the intensive thoracic unit for three days and shifted to the ward.

Myxomas are rare primary tumours of the heart, affecting 0.5 in one million population and constitutes around 0.2–0.3 % of all cardiac surgeries performed. Patients may exhibit symptoms of breathlessness, palpitations, chest pain, stroke and constitutional symptoms like fever, tiredness and loss of weight. Eventually, they develop congestive cardiac failure. Incomplete excision during surgery can lead to recurrence of the tumour. Patients can lead a perfectly normal life after the procedure.

The treatment team included cardiac surgeon Dr Gopalakrishna, cardiac anaesthesiologist Dr Rakesh M G, perfusionist Preetha, surgical assistants Sindhu, Sharyl, Lijo and other post–operative staff.

Yenepoya Specialty Hospital has a well equipped cardiac centre and has been undertaking all kinds of complex cardiac surgeries.

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