Timely and immediate therapy by a multidisciplinary workforce of medical doctors at Max Hospital, Saket, offered a brand new lease of life to a man whose heart functioned merely at 15 per cent of its capability. In addition to his issues, he had additionally developed acute renal failure submit his heart operation. However, his life was saved after a set of advanced surgical procedures.
The hospital mentioned that the man was affected by end-stage heart failure at Max Hospital and shortly after the heart transplant, he developed acute renal failure elevating the chance of organ rejection. The hospital advised that the medical doctors managed the affected person effectively, who’s now totally recovered three months after his surgical procedure.
29-year-old Raj Kumar Rawat was dropped at the emergency of Max, Saket in June in a important situation and was recognized with Class IV dyspnea (shortness of breath) and solely 15 per cent of heart operate, can be a recognized case of extreme LV dysfunction.
The hospital mentioned that medical investigations throughout hospitalization revealed that Rawat’s chest had an enlarged heart with fluid accumulation within the pleural cavity which could possibly be an after-effect of a collection of heart surgical procedures. “Earlier in 2012 he had undergone a major heart surgery at the age of 21 years, for treating the abnormal thickening of his heart muscles that caused severe disruption in the pumping efficiency of the heart. Later in 2015, the patient had a dual chamber pacemaker implantation,” the hospital knowledgeable.
“He underwent the procedure where his heart was replaced with a donor heart, and upon being hemodynamically stable he was extubated after 1st postoperative day,” mentioned Kewal Krishan, Director – Heart Transplant & Ventricular Assist Devices, Principal Consultant – Cardiac Surgeon, Max.
“Since two of his heart valves were not functioning effectively causing backward flow of the blood leading to the mixing of oxygenated blood with the de-oxygenated blood. ECHO also revealed a uniform decrease in the motion of his ventricles causing the pumping pressure to reduce to 55 mm Hg. With his deteriorating condition and looking at the history of the patient, he was advised for an immediate orthotopic cardiac transplant procedure,” he defined.
The hospital mentioned that although the blood move within the affected person’s heart was hemodynamically secure, he had intermittent Atrial Fibrillations, a situation when irregular heartbeats happen. The state of affairs could elevate to clot formation and even heart failure. Doctors advised that he was instituted with antiarrhythmic drugs and immune-suppression technique as per the protocols.
However, the post-operative investigations revealed that the affected person had developed delicate RV dysfunction with growing TLC depend. “He had to be electively re-intubated when the team observed oliguria (low Urine output) and immediately consulted the nephrology team,” Krishan mentioned.
Rawat was administered with Continuous Renal Replacement Therapy (dialysis for acute renal failure) to revive his kidney functioning. “After three days the patient showed improvement in urine output and his last Sustained Low Efficiency Dialysis (SLED) was done. As his haemodynamics improved and R.V. dysfunction resolved he was extubated and gradually started on a regular diet,” Krishan knowledgeable.
Rawat was later transferred to the final ward the place his pacing wires had been eliminated and evaluation was performed, which confirmed good biventricular features. “The rest of his recovery was satisfactory and he got discharged in stable condition to remain on close follow up,” the hospital said.