Minimally Invasive Heart Surgery At Global Health City also Ensured A Successful Liver Transplant

CHENNAI, India - May 22, 2015 - PRLog -- Chennai, 18th March 2015:  Needless to say about the importance of liver transplantation for a person with end stage liver failure. The story of this 45-year old gentle man was different and challenging. His heart had to be mended first so that he could undergo liver transplantation. Today, he is a live example of how a hopeful heart can offer hope to other vital organs.

Mr. Abdulla was suffering from severe end stage cirrhosis was referred for liver transplantation to   Global Health City. Upon presentation, he was found to have sepsis and managed in ICU.  Following the recovery from sepsis he underwent evaluation for liver transplantation. As a routine work-up for liver transplantation, he underwent a thorough cardiac assessment. During the cardiac evaluation he was diagnosed to have severe Tricuspid valve regurgitation (blood to flow backward (leak) into the right upper heart chamber (atrium)).

Dr. Dinesh Jothimani – Senior Liver Transplant Physician at Global Health City said “Presence of severe Tricuspid valve regurgitation would preclude him from having a liver transplantation, because the graft will get congested and damaged due to back flow of blood from the heart. Therefore it was important to sort out the heart problem prior to liver transplantation. However, he will not tolerate a major heart surgery, as his liver will fail completely, leading to severe morbidity and mortality. Post discussion with our cardiac surgical team, we decided to perform Minimally Invasive Cardiac Surgery (MICS)”.

Dr. M. M. Yusuf - Senior Consultant Minimally Invasive Cardiac Surgeon at Global Health City said “Performing cardiac surgery in patients with end stage liver failure carries much higher risk. In case of Mr. Abdulla Cardiopulmonary (Heart-Lung) Bypass (CPB) machine had to be used to perform valve repair. Prolonged use of CPB machine during cardiac surgery may lead to ischemic liver damage and irrevocable liver failure. Subsequent bleeding could lead to death of the patient. In addition, the cardiac surgery had its inherent complications. In traditional open heart surgery sternum splitting is the major source of bleeding, infection and cause of delayed recovery. In view of the above, a Minimally Invasive Approach to repair the valve was considered to be the best option. Thus, it reduces the tissue damage and the risk of bleeding, and preserves the patient’s original valve”.

“After having a detailed discussion with the liver team, Mr. Abdulla was taken to operation theatre and an Endoscopic Port access Tricuspid Valve Repair surgery was performed. A 7-cms incision and a 5-cms incision were made on the right mid chest and the right upper thigh fold respectively. While through the former incision the valve was repaired, the latter incision was used to access the leg blood vessels to place the patient on heart-lung bypass machine. Post the procedure, he had Very minimal bleeding due to inherent advantages of minimally invasive approach. His recovery time was extremely quick and was discharged 5-days after the surgery”, further added Dr. M. M. Yusuf.

Adding further on the occasion, Dr. Dinesh Jothimani mentioned that “After about 4-weeks time, Mr. Abdulla was admitted to the hospital for liver transplantation. The team spearheaded by Prof. Mohamed Rela performed the liver transplantation surgery and now he is recovering. He is the living example who offers hope to showcase how a team of highly skilled experts can transform a sick patient’s life”.

“Yet another patient, Mr. Mohammed Gany,  a 52 years old gentleman during his evaluation for liver transplantation, he was found to have severe coronary artery disease (triple vessel) which would have precluded him from liver transplantation. We had involved our cardiac team for further surgical management” added Dr. Dinesh Jothimani

“Unlike the surgery on Mr. Abdulla, we performed Mr. Gany’s surgery through Open heart surgery (beating heart technique) without placing him on CPB. This helped him to recover faster and reduced the risk of further liver damage. Post the cardiac surgery, he underwent liver transplantation successfully and is doing well”. Stated Dr. M. M. Yusuf

Dr. M. M. Yusuf concluded saying that “Various medical literatures across the globe reveal that combined procedure i.e. cardiac surgery and liver transplant performed in single-sitting produce better results than the staged procedures, when Minimally Invasive Cardiac Surgery or Beating Heart surgery is not possible. We are very proud that Global Health City is one of the very few centres in the world with surgical expertise and facilities to perform such staged procedures”.