Manmohan Cardiothoracic Vascular and Transplant Centre performs rare open heart surgery in Nepal

KATHMANDU: A team led by Dr Anil Bhattarai has successfully performed a rare open heart surgery of a patient with 'Type A aortic dissection with pregnancy' at Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC), under Tribhuvan University, Institute of Medicine (IOM) in Kathmandu on Thursday.

A 37-week pregnant woman (24) from Ramechhap district visited the centre yesterday morning with severe chest pain. Doctors at the centre performed echocardiography of the patient and diagnosed a Type A aortic dissection condition.

Talking to THT over the phone, Dr Anil Bhattarai said, "We successfully performed a rare form of open heart surgery of this kind yesterday afternoon. The patient might have developed this condition due to hypertension."

"In this case, we first opened the patient's lower abdomen and took the baby out and opened her chest before replacing her damaged ascending aorta with an artificial dacron graft. Later, we closed both her abdomen and chest in a seven-hour-long surgery which began at 10:00 am."

He further stated, "After Caesarean section, we took the baby out in an unconscious state, the baby regained consciousness after three hours. Today, the mother has been shifted to the Intensive Care Unit (ICU) after withdrawing her from the ventilator."

Type A aortic dissection in pregnancy is a rare, life-threatening condition with higher incidence in patients with connective tissue disease. Mostly it is associated with genetic or anatomic predisposition, such as Marfan syndrome or bicuspid aorta, according to Dr Bhattarai.

The team led by Dr Bhattarai was assisted by cardiac surgeons Dr Prabhat Khakurel, Dr Rabi Baral and Dr Nikesh Bhandari, anaesthetists Dr Biswash Pradhan, Dr Bivush Shrestha, Dr Mandira Basnet, Dr Priska Bastola and Dr Arjun Gurung.

Gynaecologists Dr Jyoti Sharma, Dr Bekha Laxmi Manandhar, Dr Suniti Rawal, Dr Sunita Bajracharya and Dr Suvana Maskey, paediatricians Dr Pradeep Paudel, Dr Kabita Manadhar from Teaching Hospital and other nursing staff were involved in the marathon surgery yesterday.

Expressing satisfaction, Dr Bhattarai said, "I am glad that we saved the mother and child and gave them a new lease of life after successfully performing such a rare surgery in my 13-year-career. I want to thank all my team members who were involved in a marathon surgery first of its kind in the nine-year history of this centre."

Acting Director of the centre, Dr Uttam Krishna Shrestha expressed happiness that the centre had successfully performed such a rare open heart surgery. "I am grateful to the team and extend my sincere congratulations to them," Shrestha added.

Earlier, Dr Bhattarai had successfully treated heart patients in remote, economically backward, marginalised, underserved communities in more than 40 districts including Rukum, Rolpa, Kalikot, Parbat and Palpa by setting up free heart camps.

In coordination with the 'Save the Heart' foundation, those diagnosed with severe heart ailment during the camps were brought to Kathmandu and returned home after successful treatment.

So far, Dr Bhattarai in his own initiation has successfully operated more than 90 patients free of cost.

Meanwhile, Dr Bhattarai is Consultant Cardiac Surgeon and Assistant Professor at Tribhuvan University Teaching Hospital and currently associated with Manmohan Cardiothoracic Vascular and Transplant Centre.