The patient, from Burla in Sambalpur, was operated for heart valve problems 12 years ago at AIIMS, New Delhi. She had a bioprosthetic or tissue valve for her aortic valve problems. The tissue valve degenerates over period of time, requiring second surgery. However, the adhesions of first surgery, distorted anatomy, advanced age and advanced disease make redo surgery more risky. Further, specialized instruments and techniques are required for better outcome.
Morbidity in cardiac re-intervention is higher than the first operation because of cardio-pericardial adhesions and more advanced cardiac pathology. Re-sternotomy carries a high risk of cardiac injury and subsequent catastrophic bleeding.
More advanced cardiac pathology is associated with increased operative and postoperative morbidity and mortality. Longer ICU stay is associated with heart valve re-operations. Redo operations are identified as risks factors for blood transfusion requirements, sternal wound infections and mediastinitis.
A team of doctors from KIMS – Dr Bana Bihari Mishra, Dr Nimai Charan Behera, Dr Ashok Kumar Badamali, Dr Jyoti Ranjan Parida and Perfusionist Mr Saumya Kanta Satpathy & Subishna Bal – accomplished this risky operation.