In India, heart related issue among men is increasing day by day but the Mumbai Hospital came across a very interesting case where an old lady presented with Mitral and Tricuspid Valve Disease. In 1982, she underwent her first heart surgery to address a mitral valve issue. This marked the beginning of her journey with cardiac health management. Subsequent to this, in 1998 and 2016, she underwent two more balloon mitral valvotomy procedures, indicating ongoing challenges with her heart valves. Unfortunately, 2016 also brought with it a diagnosis of breast cancer, leading to a rigorous treatment regimen that included mastectomy and radiotherapy. Despite the challenges posed by both cardiac and oncological issues, the patient completed her entire course of cancer treatment with resilience and determination.
Fast forward to January 2024, at the age of 73yrs, the patient approached Dr Gulshan Rohra, a Senior Cardiac surgeon at Wockhardt hospital, Mumbai Central. She was experiencing symptoms indicative of mitral stenosis and tricuspid valve malfunction. Concerned about her cardiac health, Dr Rohra recommended a comprehensive plan of action, which included replacing the malfunctioning mitral valve and repairing the tricuspid valve. However, before proceeding with the planned valve interventions, a thorough angiographic evaluation was conducted to assess the condition of her heart arteries.
To the medical team’s concern, the angiography revealed significant blockages in the patient’s coronary arteries, indicating underlying coronary artery disease. In addition to these concerns, patient also had small airway disease (on lung function test). Recognizing the importance of addressing these blockages to ensure optimal cardiac function and long-term well-being, the decision was made to include coronary artery bypass grafting (CABG) alongside the planned valve replacement and repair procedures.
The surgical intervention, which occurred under the careful supervision of Dr Gulshan Rohra and his team, aimed to address the entirety of the patient’s cardiovascular issues. During the surgery, Dr Rohra also found multiple atrial septal defects. The following procedures were performed during the open heart surgery.
1) Mitral valve replacement
2) Tricuspid valve assessment (Repair not needed)
3) Bypass surgery
4) ASD closure
Postoperatively, the patient received attentive care in the intensive care unit, where her cardiac parameters were closely monitored, and measures were taken to optimize her recovery and prevent complications.
Following her successful surgery and initial recovery period, the patient transitioned to a phase of ongoing cardiac rehabilitation and long-term management. Regular follow-up appointments were scheduled to monitor her progress, assess the functionality of the replaced and repaired valves, and ensure that her cardiac health remained stable in the years to come.
“Addressing complex cardiac issues requires a comprehensive approach, taking into account not only the primary valve pathology but also associated conditions such as coronary artery disease. In cases like these, a multidisciplinary team is crucial to ensure optimal outcomes and long-term success. Our aim is not just to treat the immediate problem but to provide holistic care that enhances the patient’s overall cardiac health and quality of life.” – Dr. Gulshan Rohra, Cardiac Surgeon at Wockhardt Hospitals Mumbai Central
The patient’s journey underscores the complexities often associated with managing multiple cardiac issues in conjunction with other medical conditions. Through a combination of advanced medical interventions, diligent postoperative care, and ongoing support, she continues to navigate her cardiac health journey with resilience and hope for a brighter and healthier future.
