Bloodless surgery for aortic valve leakageMarch 6, 2020
Uwen, a 43-year-old geophysicist from Nigeria was excessively getting tired of physical exertion for the last couple of years. It worsened so much over the last 2 years that he has to voluntarily quit his job. When investigated, he was found to have severe leakage of aortic valve leading to severe enlargement of his heart, producing heart failure. He was put on heart failure medication and asked to undergo a change of the aortic valve at the earliest.
Being a person of Jehovah faith, who do not accept any blood or blood product transfusion, it was difficult for him to find a surgeon who would accept him for surgery. When he got in touch with Jehovah community in India, he was directed to Dr Devananda NS, HOD & Consultant – Cardiothoracic Vascular Surgery and Heart Transplant, Manipal Hospitals Bangalore who has experience in treating several Jehovah patients for heart surgery.
“Mr Uwen was reinvestigated at Manipal Hospital. In addition to aortic valve leak with heart enlargement, he was also found to have gross enlargement of aortic root and early part of his aorta, medically called annuloaortic ectasia. This condition requires not only the replacement of the aortic valve, but also the replacement of the entire aortic root (Bentall Operation). This is a complicated operation and doing it without blood on the face of his poorly functioning heart (ejection fraction – 35%) which otherwise should have been 55% of a normal person was a challenge. After a coronary angiography, he was treated for 2 weeks with iron replacement and erythropoietin injections to build his hemoglobin from 13.5 gm/dL to 14 gm/dL. He underwent Bentall Operation on 03/01/2020, he had a smooth recovery and was discharged within 10 days with a hemoglobin of 10 gm/dL,” says Dr Devananda NS, sharing details of the operation.
In our knowledge, this happens to be the first case being reported in a Jehovah in India. However, Dr. Devananda who has performed heart surgeries in over a dozen Jehovah patients from 3.5 kg child to adults says this is the second time he has performed this operation in a Jehovah patient. Apart from meticulous planning the operation, good post-operative care is essential for successfully treating this challenging group of patients.
“We could do such an operation only because we have a system around, since we do operations on these kinds of patients. We also want this message also to go to many other patients who probably was denied just because they cannot use blood or blood products,” says Dr Devananda.
Manipal hospital has an experience of dealing with cases like that of Jehovah’s of all age groups from children of 3 months to adult up to 70 years.
Expressing his happiness on the treatment, Uwen Akpan Udofia said, “I have recovered completely and now leading a happy and normal life all thanks to Dr Devananda and team. The doctors have been supportive throughout the procedure and even my post-surgery follow-up reports are good. Grateful to the team that they took up this challenging surgery and at the same time keeping up with the sentiments of my belief and faith. I appreciate the efforts and commitment of the doctors.”
Apart from Dr Devananda, the team of cardio-thoracic vascular and heart transplant surgeons including Dr Murali Krishna, Consultant and Dr Lalchand H Bandagi, Consultant, Manipal Hospitals Bangalore were part of the team which conducted the procedure.