A surgery to correct abnormal heart beats

A small modification in valve replacement surgery allows surgeons to simultaneously correct abnormal heart beats of patients with rheumatic heart disease at the same cost. This saves the patient Rs 75,000, needed for the second procedure.

While various procedures to correct irregular heart beats are separately done as a routine exercise at various hospitals including the AIIMS, cardiac surgeons at Max Devki Devi Heart and Vascular Institute, Saket, have operated 12 people using the technique together with valve replacement. The enlarged left atrium, left upper chamber of heart, is cut away to bring heart rhythm back to normalcy.

Parwati Patel (42), a resident of Annupur, Madhya Pradesh, is the recent one to be operated last month. She is recovering well after the surgery. Ninety six per cent of those treated using the technique have got their heart beat back.

“The enlarged left atrial chamber is responsible for abnormal heart beats. We decreased its size by cutting away the enlarged portion along with replacing the valve. The atrium then is stitched back, and the thick scarring that’s formed in course of healing stops transmission of electrical impulses to the rest of the heart,” said Dr IS Virdi, chief cardiothoracic surgeon, Max Hospital, who developed the technique in Australia and is now performing it in India.

“Replacing valve is only half the job done, but due to monetary and technical constraints, most people were put on medication to control irregular heart beats. Medicines always have some side-effects, and in long term 40% of heart valve replacement cases tend to develop stroke and other neurological conditions which could turn fatal,” said Dr Virdi.

This surgery is especially applicable in the Indian context, where rheumatic heart disease is prevalent in 6.4 persons per 1,000 population, which leads to mitral valve disease in most of them. More than 50% of these patients have atrial fibrillation, a technical term for having irregular heart rhythms.

“There are various procedures to correct arrhythmia, which are routinely done at AIIMS. Left atrium reduction is one of the simplest and primitive ways of correcting it,” said Dr AK Bisoi, a senior cardio-thoracic surgeon, AIIMS.