A 70-year-old liver transplant patient received the world’s smallest heart pump after successful treatment at AIG Hospitals in Hyderabad.
Sashidhar (name changed) was admitted on June 14 after complaining of breathlessness, chest pain, and severe weakness. After primary checks, the patient was diagnosed with heart failure and severely decreased heart pumping (EF -28%). The septuagenarian was stabilized and an angiogram was done which revealed all three main arteries of the heart were severely blocked, including the left main coronary artery. The patient was suffering from comorbidities including post-liver transplant, diabetes, hypertension, anaemia, and acute kidney injury.
A multidisciplinary team consisting of cardiac surgeon, anesthesiologist, radiologist, liver transplant expert, hepatologist, nephrologist and lead by interventional cardiologists, Dr Anuj Kapadia Dr Rajeev Menon, Dr Swaroop Bharadi, and Dr Uday Kiran Anne.
The nephrologist managed the patient’s kidney issues and the hepatologist adjusted the immunosuppressive drug regimen. Meanwhile, a cardiac MRI was done which showed all the heart muscles were viable. However, investigations revealed a high risk of death in the case of coronary by-pass surgery. However, a non-surgical heart pump called IMPELLA, a US-FDA approved device, has brought the ray of hope.
“The biggest challenge for such high-risk patients undergoing cardiac intervention is maintaining stable pressure and perfusion to the brain, kidneys, and other critical organs. Simply put, to keep the blood flow stable while the procedure is being done,” said Dr Anuj Kapadia, Senior Consultant, Interventional Cardiology, AIG Hospitals.
The IMPELLA device known as the “world’s smallest heart pump” was inserted into the heart through the groin artery under local anaesthesia and helped stabilise heart function and ensure blood flow to critical organs during procedure. The device replicates the pumping function of the heart, providing blood flow of 3.5 litres/min. The overall procedure lasted for three hours.
“Two aspects made this complex plan a success, first the multidisciplinary heart team approach and second the IMPELLA device, which made the entire procedure seamless,” said Dr Uday Kiran Anne.
The device was safely removed at the end of the procedure itself. The patient was shifted to the ICU and was subsequently discharged after 2 days of hospitalization.
“This case was true reminiscent of what AIG stands for and that is providing holistic care using advanced technologies. We are glad that the patient is doing well and hopefully, in the coming years, these treatment options will become more accessible for all such patients. The Institute of Cardiac Sciences and Research at the AIG Hospitals continues to explore newer treatment modalities to help patients even with such extreme disease condition,” said Dr D Nageshwar Reddy, Chairman of AIG Hospitals.
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