Doctors at Fortis Noida recently performed a rare lifesaving, complex and extremely intensive surgery on a 48-year-old patient to remove a large tumour measuring 7 x 8 cms-sq. The tumour, which was similar to a cricket ball, occupied close to 60% of the heart. The team at Fortis Noida which performed this complex surgery was led by Dr Vaibhav Mishra, Senior Consultant, Cardio Thoracic & Vascular Surgery, Fortis Hospital, Noida.
The patient, Poonam, 48 years, a resident of Ghaziabad, suffered from sudden breathlessness and wheezing while her heart beat became fast and erratic. She was rushed to a nearby hospital in Ghaziabad where it was discovered that her heart function (ejection fraction) was only 25 %. The tumour, also known as Myxoma, was quite big for the heart, which measures only about 12 x 8 cms-sq. It had occupied one entire chamber of the heart (close to 60%), obstructing the flow of blood. It was very likely that in this state, the patient could have suffered from sudden cardiac death or congestive cardiac failure.
The tumour was mounting enormous pressure on the neighbouring chamber and hindered the flow of blood which led to grossly abnormal liver functions. The tumour was also very friable and could have broken apart lodging itself into the brain which could have caused a stroke. In a nutshell, considering that our heart is just about the size of our fist, the tumour was large enough to damage the heart and surrounding organs.
Dr. Vaibhav Mishra, Senior Consultant, Department of Cardiothoracic and Vascular Surgery, Fortis Hospital, Noida said, “The surgical procedure itself was tremendously challenging because of the sheer size of tumour within the heart chamber. Since it was also compressing the major structures, it became difficult to establish a cardio pulmonary bypass and stop the heart. However, we were able to remove the tumour completely from the heart and the patent made an uneventful and gratifying recovery, leaving the hospital in 6 days. Her heart function also increased and was nearly normal by the time she was discharged.”
Dr. Kousar A Shah, Zonal Director, Fortis Hospital, Noida said, “While we have piloted several complex surgeries in the past, this case could have been a lost cause when the patient reached us. I had full faith in the team and knew that they would carefully craft a method through which they could approach the problem and find the solution. They put in a herculean effort and were sensitive and intricate in their execution, aided by state of the art technology, infrastructure, trained, resourceful and skilled manpower.”
According to the Johns Hopkins School of Medicine, primary tumors are those that originate in the heart and are rare, occurring in one out of 2,000 people, occur in the age group 20-50. Tumors that originate in another part of the body and then spread to the heart are called secondary tumors. A noncancerous primary heart tumor (myxoma) usually develops in the left upper chamber (atrium) of the heart and tends to be more common among women. The symptoms of myxoma are usually that of any other cardiac disease - shortness of breath, palpitations, abnormal heart rhythm or sometimes, stroke. Surgery is the only treatment and when done in early stages, it is quite straightforward, but as the size increases the operation becomes technically demanding and risky.
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