27 year old software engineer survives a massive cardiac arrest

Wednesday, December 23, 2009

In an extra ordinary medical feat Wockhardt Hospitals,Bangalore – "A Network Hospital of Fortis, has set yet another benchmark in the history of medical science by performing a very complicated cardiac surgery on a 27 year old who suffered a massive heart attack.

Rupesh Mathur, a 27 year old engineer hailing from Bihar, complained of breathing difficulty and chest pain on 15th of November 2009 while on his way back home. As the pain increased his friends took him to a city hospital where he was diagnosed with heart attack and was initially treated with clot dissolving medicines. His family later shifted him to Wockhardt Hospitals.

“An angiogram showed severe blockage in 3 arteries. His heart was severely damaged and weakened. His life was in danger. We had to put him on an Intra-Aortic- Balloon-Pump (IABP), but he still had breathing difficulty. So he was put on a ventilator and special medication to stop clots from forming again. Surgery was the only option to save his life as his chances for survival was minimal even after surgery”, said Dr. N S Devananda, Cardiac Surgeon, Wockhardt Hospitals,Bangalore – A Network of Fortis.

“It was a big decision for his family to make him undergo surgery with less than 5% chance of survival. But his parents decided to go ahead” he added.

Rupesh underwent bypass surgery with the assistance of heart and lung machine to maintain blood circulation. Post the surgery his heart was extremely weak (Pulmonary Adema) and was not coping and he was on the verge of death, hence the doctors could not take him off the heart and lung machine.

Later the doctors decided to place him on an extra carboniam membrane operation (ECMO) and he was shifted to the ICU for 24 hours. ECMO treatment provides oxygenation until the patients lung function has sufficiently recovered to maintain appropriate O2 saturation.

It is often a last resort. Rupesh’s lungs had weakened due to poor circulation of oxygen. Keeping him on ECMO was a major challenge as his chest had to be open and his blood needed to be thin, which lead to bleeding. After 24 hours doctors tried to take him off the bypass however they were forced to put him back on circulatory support after just 45 minutes as his heart could not cope. The situation was extremely grim and doctors had left with two options 1) to keep him on life support system for further 24 hours and hope that his heart strengthens 2) A heart transplant, which was next to impossible to get a donor heart on such short notice.

On 22nd of November 2009 Rupesh was taken off circulatory system for 4 hours with his chest still open, but his heart was still too weak. Doctors put him back on circulatory support for another 12 hours after which his heart started strengthening and he was removed from the machine. 4 days later he was removed from the IABB and 9 days later he was taken off the ventilator. His heart recovered well and was discharged after 2 weeks.

Dr. Devananda said “I have never come across such a difficult case in my entire career. This is miracle, where a patient who was on mechanical life support for survival for so long recovering to live a normal life. This is truly a victory for modern technology and the never say die attitude of this 27 year old”.

These days’ young people are not immune to heart diseases and when it happens in younger people it is sudden, severe and caused more damage to the heart. Of late there is an alarming increase in the number of youngsters with heart diseases.

Young Philippino who never had a hip socket since birth undergoes revision hip replacement surgery

Orthopedic team led by Dr. Kaushal Malhan, Consultant Orthopedic Surgeon, Wockhardt Hospitals,Mulund,Mumbai performed a revision hip replacement surgery on a 29 year old girl from Philippines.

29 year old Elvira was suffering from a congenital birth defect wherein her hip bone had not developed and her hip had no cup since birth. At the age of 21 she had her first hip replacement surgery in Philippines. However the surgery was not a successful one and after a month of her operation she had to undergo a second surgery on the same hip. The second surgery was also not a success and Alvira’s left leg was shortened nearly by 6 cms due to dislocation of her hip joint. Since then she continued to be in pain and had difficulty in walking and performing all the simple day to day chores. Her physical condition restricted her life to a great extent and she lived a compromised life without being able to enjoy the pleasures that one enjoyed at her age. This left Elvira in pain, frustrated, mentally depressed and she decided to sit back home and not interact with any one, for over 3 yrs.

To distract herself and get out of her agony Elvira decided to go for her graduation in 2005 and completed Pharmacy graduation in 2009. Meanwhile destiny gave her a second chance, having suffered for so long Elvira mustered the courage to rectify her problem and decided to come down to India and get operated upon her hip once again.

“Elvira’s problem was a complicated one as she had already undergone hip replacement before and both those operations were failures. The surgeries had damaged Elvira’s bone and now we had to be very careful while performing the revision replacement surgery so as to not damage her bones any further”, said Dr. Kaushal Malhan.

“Her surgery involved removing the previous cemented Hip Replacement, and implanting new specialized components after having reconstructed the bone socket, which was had never developed since child hood. We needed to make up for the loss of bone that occurred due to lack of development and damage in the previous 2 failed operations” he added.

The length of her shortened leg was also corrected and made equal. The implants used have been put in a manner that allows her to sit on the floor without the risk of dislocation, as is seen in conventional Total Hip Replacement (THR) surgery. Elvira is very comfortable post surgery and has already started sitting properly in a manner which she has not been able to do for years. Her pain is completely reduced and now she is hoping to study further to become a doctor.

“My parents consulted a Pediatric doctor at Philippines to sort my problem but we could never get the right direction and the Doctors were not able to offer any solution as mine was a birth defect. Since then I had a compromised gait and could not do all those regular activities which a child of my age used to. When both my surgeries failed I almost lost all hopes and the thought of living a challenged life devastated by morale. But like the saying goes every cloud has a silver lining! I too saw some hope after 8 years. My fiancĂ© read about total hip replacement surgery in a magazine and we got curious and searched on the internet to know more about it. That’s when we read about the credentials of joint replacement surgeries at Wockhardt Hospitals and expertise of various joint replacement surgeons including Dr. Kaushal Malhan who has done some interesting and compelling replacement surgeries. Hence we contacted Wockhardt Hospitals and once everything was finalized we decided to fly down to India for my surgery” said Elvira.

“I no longer have to limp, I am no more in pain and most importantly I can now do everything I had dreamt of doing all these years. This has given a new meaning to my life and I would like to make the most of it now without losing a single opportunity!! All I want to say is there is a solution to every problem, only thing is we need to hunt out for the opportunity and everything else falls in place”, says Elvira with a comforting smile on her face.


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