In a breakthrough medical feat, surgeons at Aster RV Hospital in JP Nagar, Bengaluru, successfully performed a high-risk redo open-heart surgery on a 40-year-old Nepalese woman suffering from significant heart problems caused by rheumatic heart disease. Led by Dr. Divakar Bhat, Consultant in CTVS Surgery, the team replaced a leaking heart valve while also reducing the size of her enlarged heart, saving her life. 

The patient, Mahima (name changed), had heart valve replacement surgery two decades ago. While she had a relatively healthy life following surgery, her health began to deteriorate three to four years ago, with recurring breathing problems and leg oedema. Further investigations indicated a greatly enlarged heart—the right atrium had swollen to 10-11 cm and the left atrium to 7-8 cm, more than twice their normal size. Despite the successful replacement of the original valve, we discovered a serious leak in another valve.

"Redo surgery in such cases is always a high-risk procedure," Dr. Bhat explained. "The main problem was not only replacing the damaged valve but also lowering the size of the heart, which had become so huge that it could lead to decreased cardiac function and serious consequences. We were certain that we could help her using advanced surgical techniques and technologies." 

The complicated surgery required a second sternotomy to gain access to the heart. The crew carefully replaced the leaking valve with a new metallic one, conserving the previously replaced valve. To treat the enlarged heart, the surgeons used a procedure similar to folding a saree, employing precision stitches to shrink the heart's size by nearly half while maintaining its functions. 

Furthermore, the team inserted an epicardial bipolar lead to prevent potential consequences such as heart block and to ensure the patient's long-term stability.

The immediate success of the surgery was evident. Mahima recovered quickly despite facing significant physical and financial hurdles. Her breathing improved dramatically, and the oedema in her legs decreased. Reflecting on her experience, she expressed deep gratitude: "At first, I was nervous because this was my second heart surgery. My husband's boss, who helped us financially, reassured us about the hospital and the doctors. The doctor not only healed my heart but also made us feel comfortable." Seeing my husband smile after the operation gave me immense relief." 

Dr. Bhat stressed the case's rarity, pointing out that advances in contemporary medicine have reduced the incidence of rheumatic heart disease. "However, when it does occur, it can lead to life-threatening complications like the one we faced here," he said. 

Financial aid from numerous sources guaranteed that the patient's procedure could go into place without delay. The technique emphasizes the necessity of novel surgical procedures and compassionate care when dealing with difficult medical issues.  Mahima is now looking forward to returning to a healthy, meaningful life, due to the Aster RV Hospital team's skill and dedication. \