SSKM doctors perform rare heart surgery

Doctors at SSKM hospital performed a rare surgery on a 33-year-old woman who had come to the hospital few days ago with a rare and complex congenital defect in her heart. 

Doctors in the hospitals said that it was a case of partial endocardial cushion defect, otherwise known as atrioventricular canal defect with cleft of anterior leaflet of mitral valve with tricuspid regurgitation.  

The patient, Kalpana Sharma, a resident of Tehatta in Nadia was admitted to the Cardio Thorasic Vascular Surgery (CTVS) department of the hospital under Dr Prakash Sanki, an associate professor. Echocardiography confirmed that the patient had a congenital heart defect.

 In last 2-3 years the patient’s respiratory distress was aggravated to such an extent that she could not lead a normal life. According to Dr D Mandal who was a member of the 3-member team of doctors performing the surgery, the symptoms of the disease generally become evident when a patient is at the age of 1/2 years. It is quite unusual that the patient got to know about the symptoms at the age of 33. The patient used to suffer severe respiratory distress due to the congenital heart defect. Dr P Jain was another member of the team. Dr D Mandal said that the patient was operated under cardiopulmonary bypass. Her heart was opened through right atrium. It was found that there was a big atrioventricular septal defect. On further examination it was also found that there was a cleft in the anterior leaflet of mitral valve. The patient had severe regurgitation of tricuspid valve. She had this defect congenitally but was not detected till her adulthood. There is always a high risk operating a patient at this age.  Tricuspid regurgitation has happened as a result of the partial atrioventricular canal defect in which the right side of the heart gets overloaded with blood. As a normal valve is handling too much blood the regurgitation happens.  The defect was very close to the conduction system of the heart. There was a high risk of injury to the conduction system in the process of closure of the defect. Patients are often found to have developed a block in their heart post their operation. But in this case there was no blockade. The cleft in the mitral valve was repaired by interrupted sutures. The congenital atrioventricular defect was repaired with autologous pericardial patch (harvested from patient’s own pericardium). Tricuspid valve annuloplasty was done with ring.

 Citing a medical journal report Dr Mandal said that the incidence of this disease is found in 2 persons out of every 50,000 births and most of the patients die in mother’s womb. The doctors released the patient on Friday.