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Uzbekistan Patient with ASD treated at FEHI in a scar less surgical procedure to treat the heart defect

Date : November 22, 2016

In a surgical procedure, first of its kind in India, Fortis Escorts Heart Institute once again displayed exemplary skill and expertise in treating a young patient from Uzbekistan with a congenital heart defect called Atrial Septic Defect (ASD). The surgery was led by Dr. Yugal Mishra, Director Cardiovascular Surgery, Fortis Escorts Heart Institute.

Toshikinov Doniyor, 18 years of age, suffered from pain in the left chest for over two years. On consulting local doctors he was diagnosed to be having a congenital heart defect. Atrial Septal Defect (ASD) is a birth defect of the heart in which there is a hole in the wall (septum) that divides the upper chambers of the heart (atria). This results in blood shunted also into the right atrium besides going into the left ventricle. Consequently, this leads to the dilation of the right side of the heart. A hole can vary in size and may close on its own or may require surgery. In due course, without timely intervention, this will cause pulmonary hypertension and ramify in the failure of the right side of the heart.

The typical symptoms of this condition are breathlessness while walking or climbing stairs, pain the chest, and inability to walk for a long time or long distances; Skipped heartbeats or a sense of feeling the heartbeat; A heart murmur, or a whooshing sound that can be heard with a stethoscope and Swelling of legs, feet, or stomach area.

The patient was counselled about a surgical procedure to treat the defect. After consulting multiple doctors in his own country and few other countries he could not find a doctor to conduct a scar less or a minimal invasive surgery with a minimal scar.

Dr. Mishra took up this challenge and agreed to treat the patient the way he wanted. He has applied the most innovative approach to conduct a non-conventional surgery to meet the challenges presented in such young patients.

Dr. Yugal Mishra, Director Cardiovascular Surgery, Fortis Escorts Heart Institute says, “The challenges were in using minimal invasive instruments putting heart ports; visibility into the area of treatment; adopting peripheral bypass to conduct the surgery. With the success of this method we will be able to treat more patients with similar medical conditions in a scar less manner.”

The incision given on the patient’s chest is almost invisible as it is in the fold of the areole, just beneath the nipple. Four to five centimeters long, it looks almost like a mere birth defect. With the absorbable and melting stitches given to redo the incision, the invisible scar will almost disappear in due course of time.

Dr. Somesh Mittal, Zonal Director, Fortis Escorts Heart Institute said, “This is one more feather in our caps. Fortis Escorts Heart Institute has always been striving to achieve innovative methods in cardiac treatment solutions. With this surgical procedure positioned as the first time in the country, we come out again unsurpassable in the skill and expertise our doctors apply to their patients.”

According to available data, congenital heart diseases as a whole are detected in 8-10 babies out of every 1000 live births. In India, with the country being so huge in population and a birth rate to match, the incidences of congenital heart defects is estimated to be enormous. With studies showing almost 10% of infant mortality due to congenital heart diseases, the toll of the burden of heart diseases in children poses a serious burden on the nation. ASD itself constitutes for about 6 – 8 % congenital heart diseases and is said to occur almost twice as much in girls than boys. This also constitutes for about 40% in adults if it goes undetected until the patient is an adult.

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