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Reflecting its commitment to save lives by continuous improvement and innovation, the team of cardiac surgeons at Fortis Malar Hospital, in a rather rare event, performed heart transplant surgeries on an Iraqi brother-sister duo successfully. The team led by Dr. K R Balakrishnan and Dr Suresh Rao , not only gave the duo a new lease of life, but also raised a ray of hope in many more children suffering from end stage heart failure.
Mohammed Sabah Sulaiman and Safaa Sabah Sulaiman, aged 16 and 13 years respectively, were suffering from dilated cardiomyopathy, a condition in which the ventricles in the bottom chambers of the heart dilate and weaken. This eventually results in a condition where the heart is unable to pump blood effectively. If not treated on time, it can lead to heart failure and consequently, death.
Mohammed was presented to the doctors with complaints of vomiting and breathlessness. His condition worsened as he suffered multiple episodes of seizure. He was admitted with severe LV dysfunction, a condition in which the heart's ability to pump blood is decreased because the heart's main pumping chamber, the left ventricle, is enlarged and weakened and he was put on a temporary LVAD (centrimag) immediately.
A month later, when a heart was available for transplant Mohammad was taken up for surgery immediately. While the surgery was successful, his post-surgery recovery period threw up a few challenges in his medical condition. The doctors immediately applied appropriate treatment solutions to rectify them and Mohammad slowly improved. Two weeks later, a CT scan revealed signs of further improvement and he was discharged.
Shortly after their son’s critical surgery and recovery, the family was faced with another medical emergency when their daughter, Safaa Sabah Sulaiman, complained of abnormal breathlessness and swelling of legs. Safaa was facing the same medical condition as her brother had faced earlier.
Again destiny played a positive role when a heart was again available for transplant and Safaa could get the appropriate medical treatment urgently required. The doctors performed a transplant surgery and again faced the challenges of Safaa suffering the same condition post the surgery as Mohammad had undergone earlier. The procedures applied in her brother’s case were replicated and that resulted in a positive outcome.
Dr. K R Balakrishnan, Director, Cardiac Sciences, Fortis Centre for Heart Failure and Transplant, at Fortis Malar, said, “Both of them had a dilated cardiomyopathy, a heart condition which was rapidly deteriorating and a transplant was absolutely essential. They were at high risk if the transplants weren’t performed. Though the procedure was technically difficult and challenging, these brother and sister have made a steady recovery post the surgery and are now leading normal lives. Advances in medicine have made heart transplants safer and a real option in managing cases of end stage heart failure. Our goal is to provide the highest quality of patient-centered care to many more patients, right here in India, utilizing our interdisciplinary approach, enormous talent and the multi-skilled resources within our team.”
Commenting on the two successful heart transplants of the siblings, Dr Suresh Rao, Head, Cardiac Anaesthesia and Critical Care, Fortis Malar Hospital, Chennai said, “It came as a surprise when we saw both siblings suffering with a dangerous heart ailment together. Dilated cardiomyopathy is most commonly diagnosed between ages 20 and 60, but when a 13 or 16 year old child is suffering then it becomes a critical and complicated issue. We had some tense moments when Mohammed could not tolerate extubation in the post-operative period, and had to perform a percutaneous tracheostomy, which helped us to wean off the ventilator, but the transplants were very successful and the family is finally happy.”
The elated parents of the siblings said, "The year began with a lot of stress for us but with both our children gifted with a new lease of life, we are extremely grateful to the doctors at Fortis Malar Hospital. We are also deeply humbled and indebted to the donor’s family as it was their generous decision that saved the lives of our children. We hope to see our children grow up and become successful in their future endeavors."
About Fortis Centre for Heart Failure & Transplant
Fortis Centre for Heart Failure Management and Heart Transplant is India’s first Ventricular Assist Device (VAD) Destination Therapy Center, a bridge to a transplant incase it is required later. It comprises of a team of physicians, coordinators and nursing staff, who are highly trained individuals with many years of experience in the field of transplant and heart failure management providing pre-operative, peri-operative and post-operative care. The centre has various comprehensive heart disease management programmes that include preventive measures to avoid Heart Failure, Cardiopulmonary testing including peak oxygen consumption measurement, ECMO (lung heart machine) as a bridge to a transplant or a bridge to a decision; nutritional counselling designed to help patients adhere to a complex medical regimen and a specialized low-sodium (salt) diet.
The cardiac Transplant team at Fortis Malar has so far performed 122 heart-transplants; 10-VAD’s and is credited with India’s first successful implantation of Heartmate II LVAD and HVAD, a mechanical artificial heart pump and Inter-state heart transplant.
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In a first-of-its kind transplant surgery, a team of senior doctors from Fortis Malar Hospital conducted a successful bilateral lung transplant on twenty one year old Ukrainian patient, Mr. Prokopchuk Andrii who was critically ill due to pulmonary hypertension in lungs. The challenging surgery of transplanting a pair of new lungs was performed by the team led by Dr. K R Balakrishnan, Director, Cardiac Sciences and Dr. Suresh Rao K G, HOD Critical Care & Cardiac Anesthesia. The patient was diagnosed with pulmonary hypertension and high lung blood pressure; due to the pulmonary hypertension the heart’s right ventricle started to function below the optimal level. The expert’s at Fortis Malar Hospital performed the transplant surgery to help the patient recover from.
Hailing from a nuclear family, 21-year-old Andrii was rushed to a hospital at Kiev Capital of Ukraine a year ago when he complained of breathlessness. Upon admission, doctors discovered that Andrii’s lung condition was deteriorating due to increased lung pressure and right ventricular dysfunction and his skin color started to change to blue. Keeping in mind the medical history of Andrii and his heart conditions, the doctors recommend seeking further treatment in India.
Andrii was admitted to Fortis Malar Hospital on 20th October 2016, where the doctors led by Dr. K R Balakrishnan identified the solution to Pulmonary Hypertension and right ventricular dysfunction. While a heart and lung transplant was strongly recommended, the expert team at Fortis Malar treated the patient with a bilateral lung transplant to resolve pulmonary hypertension, preserving his heart.
Dr. K R Balakrishnan, Director - Cardiac Sciences, Chief Cardiothoracic & Transplant Surgeon, Fortis Malar Hospital, Chennai said “Mr. Andrii had Pulmonary Hypertension – disease of pulmonary blood vessels, a lung condition which was rapidly deteriorating and a transplant was absolutely essential. He was at high risk of early death if the lungs weren’t transplanted. Though the procedure was technically difficult and challenging, he made a steady recovery post the transplant surgery and is now leading normal life. Advances in medicine have made bilateral lung transplants safer and a realistic option in managing cases of end stage lung failure. Our goal is to provide the highest quality of patient-centered care to many more patients, right here in India. The lung transplant program of Fortis Centre for advanced heart failure and transplant is a recognizable program in the country with exceptionally good outcomes.”
Commenting on this landmark surgery, Dr. Suresh Rao K G, Head, Cardiac Anaesthesia and Critical Care, Fortis Malar Hospital, Chennai said, “This is the first ever instance in South India where a bilateral lung transplant has been performed for pulmonary hypertension with right ventricular dysfunction. Andrii was suffering from severe breathlessness and heart failure. We medically managed his heart failure and decided to undertake lung transplant surgery to treat his pulmonary hypertension. Post-transplant, two to four days were crucial, as they would determine whether the patient’s body has rejected or accepted the new organ. The patient was administered immunosuppressant’s, which makes them vulnerable for infection. We have to balance between organ rejection and infection. His Right ventricle has totally recovered now.”
“Until I came to India, I did not believe in miracles but now I am extremely grateful to the doctors at Fortis Malar Hospital. After a long struggle I am finally going to go back to Palestine and reunite with my kids and rest of the family. This is the ultimate gift to me”, said Andrii’s mother.
Today, couple of weeks after his discharge, Andrii is walking and getting back to a normal life, his parents are extremely thankful to God and team of cardiothoracic experts at Fortis Malar for giving their son a new lease of life and for giving them a reason to be happy again.
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