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  • Rare heart surgery for Myocardial bridge in LAD coronary artery heart vessel performed in Lilavati Hospital

    Published on December 9, 2023

    Mumbai: A team led by Dr Pavan Kumar, Consultant Cardiac Surgeon with Lilavati Hospital, carried out a rare and complex Deroofing Myotomy and coronary artery bypass surgery on a 48 year old UP man detected with a congenital heart vessel abnormality known as Myocardial bridge. According to the doctor, the de-roofing procedure is 100% safe for treating this condition.

    Mr. Mohammad Waris, a resident of Moradabad, UP, had been battling angina, or chest pain, for the past four years. Despite receiving full medical treatment and undergoing two coronary angiographies that revealed a Myocardial bridge obstruction in his left anterior descending artery (LAD), he didn’t find any relief. He suffered a minor heart attack this year which his health deteriorated further. He was referred to Lilavati Hospital where he was given another chance of life.

    Dr Pavan Kumar, consultant cardiac surgeon, Lilavati Hospital said, “ Was admitted in 2nd week of November with symptoms of chest pain. A myocardial bridge is a congenital anomaly where a portion of the coronary artery travels under a band of heart muscle, rather than on top. This abnormal positioning can lead to the artery being squeezed when the heart beats, leading to changes in blood flow. These changes can potentially cause chest pain, reduced blood supply to the heart muscle, heart attacks, irregular heartbeat, and even sudden death due to cardiac arrest. The left anterior descending artery (LAD) is most frequently impacted by this condition.  Symptoms such as chest pain are noted in 2%-6% cases detected during angiography. Diagnosis typically involves using CT Scan coronary angiography to identify any muscle abnormalities in the heart and assessing dynamic blood flow during angiography with Intracoronary Doppler and F.F.R., which reveals any decrease in blood supply in the coronary artery during different stages of heart contraction and relaxation.”

    Dr Kumar elaborated that in 70% of cases, the onset or termination of a myocardial bridge experiences atherosclerosis or blockage, leading to heart attacks. Most patients respond to medical treatment, but those who don’t necessitate surgical intervention for bridge removal. The preferred treatment involves heart surgery for the unroofing of the myocardial bridge, either with or without coronary bypass surgery. He successfully completed a Deroofing Myotomy procedure on the myocardial bridge and coronary artery bypass surgery.

    “Myocardial bridge in Coronary arteries is a common abnormality and is usually treated by physicians, most of the time patient’s symptoms are ignored thinking that it is a harmless condition. Patients with this condition suffer from heart attacks, and rhythm disorders, and should seek treatment. Surgery option must be considered if the patient is symptomatic,” highlighted Dr Kumar.

    “Usually, patients with this condition undergo stent angioplasty. However, due to the constant contraction and relaxation of the heart muscle during its activity, these stents often fracture inside the myocardial bridge. Therefore, angioplasty should be avoided under such circumstances. I have personally handled four cases where stent fractures occurred following angioplasty treatment. However, this particular patient needed a de-roofing procedure on his myocardial bridge and Bypass surgery because his coronary artery was also blocked at the exit of the myocardial bridge.  The heart surgery of de-roofing of obstructing myocardial muscle is a 100% safe and successful option for this disease.

    I was having immense chest pain that interfered with my daily routine. I found solace upon reaching Lilavati Hospital. The grace of time was on my side, aiding in getting a much-needed medical intervention quickly.  Dr Pavan Kumar and his team worked tirelessly in tandem with cutting-edge technology, carving out an incredible treatment plan and saving my life. The unforgettable ordeal turned into a story of survival thanks to the timely treatment at Lilavati Hospital,” said patient Mr. Mohmmad Waris.

    “With the dynamic combination of cutting-edge technology and proficient medical experts, Lilavati Hospital serves as a ray of hope for those battling severe cardiovascular diseases and require immediate intervention, “concluded Lt. Gen. (Dr) V Ravishankar, Consultant Cardiovascular surgeon, and Chief Operating Officer, Lilavati Hospital.

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