Chennai: In a first of its kind hybrid ASD device implant in India, doctors at a private hospital here recently performed an echo guided keyhole cardiac surgery on a 31-year-old pregnant woman from Iraq. According to the hospital, the patient has recuperated well and can now look forward to a normal life.
Intisar Kareem Naser into her 3 months pregnancy was admitted with episode of minor stroke with seizures and transient weakness in her left hand. When Naser arrived at Global Health City she was diagnosed to have 25 mm ASD (atrial septal defect) with transient ischemic attack (TIA) and paradoxical embolism, according to a statement issued by the hospital.
The doctors in Iraq advised surgical ASD closure, with the risk of loosing the child and with the risk of excessive bleeding in mother during the surgery. Arkan Kutaif Owain Zaibil decided to shift his wife for further treatment to Global Health City.
Dr R Ravi Kumar and Dr Nandkishore Kapadia of Global Health City first reviewed the patient and ruled out the option of an open heart surgery due to high risk of abortion and threat to the life of the unborn child. The doctors also ruled out cath lab device closure of ASD to be risky since it could induce anomalies in the unborn child due to radiation exposure.
“This is a very rare complex clinical situation which occurs in 0.1 per cent across the world. Whenever such situation exists, the first objective is to save mother and then the child, since mother’s life is at highest risk. Innovative medical therapies like hybrid procedures for deploying devices to close holes on heart are a boon to treat heart diseases in pregnancy,” said Dr R Ravi Kumar, senior consultant, interventional cardiology, Global Health City.
The doctors at Global Health City after due consideration decided to close the ASD via a small (2 inch) incision to right chest (4th ICS) and deployment of a 28 mm ASD device – which is a double disc mesh made of Nitinol. During the surgery, the double disc was pulled inside a 4.5 mm diameter sheath and the sheath used to move across the ASD through a small pin sized cosmetic incision made in the right upper side of the heart (right atrium). Bleeding was controlled using a purse string. The passage of the sheath and device was monitored using a novel echo probe attached to the patient’s chest during surgery.
According to Dr Nandkishore Kapadia, senior consultant, cardiothoracic and vascular surgery, Global Health City, the patient was stable in ICU and the recovery was uneventful. “Ms Intisar Kareem Naser is back to normal life and is back on her feet on the third day,” he said.