HeartMate II LVAD gives Maldivian woman fresh lease of life

Bengaluru : Hafeeza Ahmed (48), a Maldivian, undergoes a complex HeartMate II LVAD implant, known to be the first successful surgery on a 47-kg patient, the lowest BSA (Body Surface Area) in India.

The medical experts from BGS Gleneagles Global Hospital performed the rarest heart surgery, on Hafeeza, who experienced congestive heart failure for the past seven years.

Looking at her rapid plunging health condition, and no signs of getting an immediate heart donor, the medical experts decided to implant HeartMate II LVAD (Left Ventricular Assist Device).

The team of cardiologist, anaesthesist and transplant surgeon prepared a robust plan to successfully perform this surgery, to give Hafeeza a chance to live a normal life.

Heart failure is a result of coronary artery disease, valvular heart disease and also due to an improper lifestyle such as poor diet, obesity, smoking, lack of exercise, excessive alcohol consumption, stress, etc.

Hafeeza was admitted to the hospital on February 21, with the complaint of breathlessness. She has been suffering from heart ailment, since 2013, with 2 – 3 admissions in ICU every year. Her medical reports clearly indicated that both her left and right ventriculars were functioning poorly.

The only chance of her survival lay in heart transplant or LVAD. Without any further delay the doctors listed her name for cadaver heart transplant. With a patient who has suffered from 2 cardiac arrests and 8 times admissions to the ICU facility due to massive heart failure, was a big risk to wait for a transplant.

Dr Ravindranath Reddy, HOD & Senior Consultant - Cardiology, BGS Gleneagles Global Hospital, said, "Hafeeza was admitted to our hospital in a very feeble condition.

Her survival chances were less than 10 percent, for the next 3 to 6 months, if right treatment was not provided to her. The whole team prepared well and followed all the COVID protocols before performing the surgery."

"In most cases, the LVAD is implanted in two situations either as a "bridge to transplant" or a "destination therapy", in both cases the survival rate is 1-2 years, close to 85 - 90 percent, similar to heart transplant."

The doctors prepped up for a complex heart surgery on March 5 and made sure that there were no stones unturned. The surgery lasted four hours, and during those crucial hours doctors implanted HeartMate II pump which is larger or bulkier than the newer generation pump. This pump has an inflow cannula and an outflow graft.

It has a drive line connected to power source which remain outside the body. After the transplant, the patient was provided with proper ICU care.

Dr Bhaskar B. V, Sr. Consultant and Head - Cardio Thoracic Surgeon, BGS Gleneagles Global Hospital said, "In most cases, doctors suggest implanting LVAD, to assist the patient's heart to pump blood successfully to other part of the body, until she finds a donor for the transplant or to give some relief from the symptoms and help other organs to function properly."

"Though it is a bit uncomfortable to adjust to the device in the beginning but slowly they get used to it and get back to their normal lives. However, they must take strict precautions and keep track of their heart on the daily basis and follow their doctor's instructions to avoid any episode"

The complex surgery was performed successfully by a team of experts including Dr Bhaskar B. V (Chief Cardiothoraic & Transplant Surgeon), Dr Madhusudhan (Consultant Cardiac Surgeon), Dr Shivprakash S (Senior Cardiac Anaesthesist), Dr Ravindranath Reddy (Sr. Consultant, Cardiology), Dr Gyandev (Consultant Cardiology).

Joice Inbarani, Chief Nursing Officer, BGS Gleneagles Global Hospital said, "Hafeeza's case was one of the most complex international cases that we have handled till date and would have been difficult to execute the plan smoothly, without the support of the doctors and the CTVS nursing team.

The recovery phase after implanting LVAD is the most crucial part of the treatment. After the surgery the patient is highly prone to develop infections if sufficient care and right medication are not provided to the patient."

"The patient is responding well to the medication and is infection free, due to the constant support of the medical staff and is all prepared to get discharged on March 22nd, 2021."

Hafeeza is currently out of danger and with this pump in place, she can perform all her routine physical activities except swimming.