Omani man undergoes ‘5th repeat open heart’ surgery in Mumbai

Mumbai, Nov 22:  In a medical feat, doctors here successfully performed a fifth repeat open heart surgery on a 24-year-old man from Oman.

The patient Khattab Omar Rashid was admitted to Jaslok Hospital and Research Centre in Mumbai on October 9 in a critical condition, experiencing heart failure and an active infection.

He had previously undergone four open heart surgeries, the most recent one being about two months ago in another hospital in India.

The first operation addressed a birth defect of the heart (subaortic membrane removal). Subsequently, he required another operation to correct the aortic valve, which was replaced.

However, a leak developed beside the valve, leading to two more surgeries in Oman. Despite a surgery in India for the infected valve, the patient continued to experience complications, ultimately being diagnosed with an ascending aortic aneurysm -- a condition where the main blood vessel from the heart becomes dilated like a balloon, carrying a risk of rupture.

Managing an aortic aneurysm, particularly when it has eroded the back of the breastbone, and undergoing repeat open heart surgery is an exceedingly high-risk procedure, said the doctors at Jaslok.

The procedure poses significant risks, including excessive bleeding and potential damage to vital organs such as the brain, kidneys, and liver, especially when there is an active infection, they added.

"5th repeat open heart surgery is rare and poses extreme technical challenges, considering the inherent risks associated with such multiple open heart surgeries and the intricate nature of the recent procedure,” said Dr. Suresh Joshi, Director Cardiovascular & Thoracic Surgery at Jaslok, in a statement.

During the surgery, the aneurysm was removed along with the infected aortic heart valve, and the aortic root was replaced with an aortic homograft -- a tissue graft obtained from a cadaveric donor in Chennai.

The use of a homograft, is a preferred option in the presence of infection, and is uncommon due to the scarcity of organ donations and valve banks.

“This is the first-time homograft is successfully used in recent times in Maharashtra and perhaps in the whole of India in case of a 5th repeat heart surgery,” added Dr Upendra Bhalerao, Cardiovascular & Thoracic Surgery, at Jaslok who assisted the surgery.

Rashid is doing well and was discharged on November 8, the doctors said.