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Doctor in Dubai performs heart surgery while patient is awake

Cardiologist replaces mitral valve in 62-year-old patient who could not handle general anaesthesia due to lung disease

Image Credit: Ahmed Ramzan/Gulf News
Dr Girish Chandra Varma, specialist cardiologist at NMC Speciality Hospital, with his patient Awaran Kutty.
Gulf News

Dubai: A cardiologist in Dubai conducted a life-saving valve replacement surgery on a 62-year-old patient while he was awake, the first such surgery performed in the Middle East.

The surgery, known as Awake Mitral Valve Replacement (MVR), was carried out on March 2 and the patient has made a rapid recovery.

Dr Girish Chandra Varma, specialist cardiologist at NMC Speciality Hospital, said he had replaced the mitral valve for the first time while the patient was ‘awake’ and could move his limbs and head.

Awaran Kutty, a 62-year-old Indian expatriate working as a gardener, told Gulf News that he was in very poor health for some time. “I suspected it was a heart problem as I would get this sudden jerk on the left side of the chest and felt breathless. Now after the surgery I am able to stand and walk. I am confident I will feel perfectly healthy once I recover from the surgery.”

Dr Varma explained the condition: “An echocardiogram and angiography revealed that the patient had a grade 4 leak in his Mitral Valve which was the absolute final stage and could have turned fatal. Usually, when the left ventricle contracts, the mitral valve opens and pushes the blood into the aorta. However, due to leakage, blood leaks into the left atrium hitting its roof and also draining back into the ventricle. If left unattended this faulty valve would have resulted in back pressure to the pulmonary veins, the lungs and would have led to heart failure.”

Dr Varma explained the reasons for doing the surgery while the patient was awake. “This decision was taken in consultation with anaesthesiologist Dr Prashant Sagar as the patient had lung disease because of a long history of smoking and could not handle general anaesthesia. The only way his valve could be replaced was by using a local epidural and putting him under mild sedation. This also allowed a quicker recovery.”

A day before the surgery, Dr Sagar surgically placed a catheter to inject the epidural in the patient’s neck. During the surgery that lasted three and half hours, the patient’s thoracic cavity was opened while he was on the heart lung machine, Dr Varma was able to snip away the diseased valve and put in the special titanium alloy mechanical valve with a lifetime warranty.

This procedure will allow the patient to resume his work and lead a good quality of life.

What is a mitral valve?

The mitral valve is one of four valves in the heart. It is located between the left atrium and left ventricle and regulates the flow of blood from the lungs into the left ventricle, the main pumping chamber.

Oxygen-rich blood comes from the lungs and fills the left atrium. It then passes to the left ventricle from where the blood is pumped into the rest of the body.

The mitral valve closes to keep blood from leaking back when the ventricle contracts.

In case of a leaky mitral valve, the blood is regurgitated to the left ventricle and the left atrium making the heart pump harder, resulting in breathlessness, fatigue, fluid build-up and eventually heart failure.

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