Team of doctors at Super Speciality Hospital handled a rare case, where it conducted two surgical procedures on a young pregnant woman saving two lives -- of hers and another of foetus. Nagma Sheikh, a 27-year old woman, a resident of Dharni, district Amravati had complaints of breathlessness and palpitation. The hospital in her area reffered her to Super Speciality Hospital (SSH). The woman underwent thorough investigation after which she was diagnosed of having coarctation of Aorta and severe Aortic stenosis. Coarctation of aorta means the narrowing of the large blood vessel (Aorta). It leads from the heart and most importantly it takes blood to uterus also apart from other body organs. Here in this woman’s case, she as well as her foetus too needed care, explained Dr Satish Das, the main Cardio-Vascular-Thoracic Surgeon, who led both the procedures.

 

The woman also had a problem of severe aortic stenosis. In this condition, narrowing of the valve in the large blood vessel takes place. During her first pregnancy, she had history of high Blood Pressure (BP) only. She had normal delivery at Primary Health Centre (PHC), Anjangaon Surji with no other complications during or immediately after delivery. She has a-6-year old son who is absolutely normal with no cardiac complaints. This is her second pregnancy. During pregnancy major physiological changes occur in body. The changes on heart and lungs make it difficult for anaesthesiologist to provide anaesthesia safely, said Dr Lulu Fatema Vali, Professor and Head of Department of Anaesthesia. Apart from her pregnancy, the person had 2 stenosis lesions, coarctation of aorta and severe aortic stenosis in heart. This situation was a challenge for anaesthesiologists.

 

They were to take care of mother as well as the foetus safe. She was anaemic too. First procedure was repair of coarctation of aorta. It was done under general anaesthesia with double lumen tube with one lung ventilation in through posterolateral thoracotomy incision in right lateral position by putting a PTFE polytetrafluoroethylene graft to have unobstructed proximal to distal (DTA) descending thoracic aorta . Second procedure involved the replacement of the severe aortic stenosis valve. It was done after 1 month under general anaesthesia through midline sternotomy incision under cardiopulmonary bypass (CPB). Both the surgical procedures and recovery from anaesthesia went uneventful. During both procedures, obstetricians were standby in Operation Theatre for maternal and foetal monitoring. It was very challenging for both surgeons and anaesthesiologists. They had to take care of patient and foetus during the procedure and post-procedure.

 

The woman will be kept in SSH till her delivery takes place. According to Dr Das, she would require all the back-ups during the delivery. The team has extended its thanks to Dr Raj Gajbhiye, the Dean of Government Medical College and Hospital and SSH. The teams those took pains to save two lives included Anaesthesiology team: Dr Lulu Fatema Vali: Professor and Head of Department; Dr Ashutosh Jaiswal : Assistant Professor; Dr Ketaki Ramteke: Assistant Professor; Dr Payal Kankal : Senior Resident; Dr Shweta and Dr Aman: Junior Residents. CVTS Team - Dr Satish Das : Professor and Head of Department; Dr Kunal Rawekar : Assistant Professor; Dr Tejas Dandekar : Assistant Professor; Dr Ameya Gadkari : Assistant Professor Perfusionist: Prachiti Deshpande and Vinay Shimpi; Officer on Special Duty (OSD) of SSH Dr S N Parate, Hospital Administration Head: Dr Shailesh Gahukar and all the nursing staff of CVTS OT and recovery.