Post-Liver Transplant patient with severely decreased heart pumping function successfully treated at AIG Hospitals with “world’s smallest heart pump”

 

Hyderabad, 28 June: Sashidhar (name changed) aged 70 got admitted at the AIG Hospitals on 14^th June with complaints of breathlessness, chest pain, and severe weakness. After primary diagnosis with ECG and ECHO, the patient was diagnosed with heart failure and severely decreased heart pumping (EF -28%). Patient was stabilized and angiogram was done which further revealed all three main arteries of the heart severely blocked, including left main coronary artery. The comorbidities list of the patient was long one with post liver transplant, diabetes, hypertension, anemia, and acute kidney injury.  

A multidisciplinary team was formed 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 patient’s kidney issues were managed by the Nephrologist and Hepatologist adjusted the immunosuppressive drug regimen. Meanwhile cardiac MRI was done which showed all the heart muscles were viable. However, upon evaluation from the Cardiac Surgery team, it was found out that the risk of mortality in case of coronary by-pass surgery is extremely high. Usually, these patients are left with no options, but a new 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 brain, kidneys, and other critical organs. Simply put to keep the blood flow stable while the procedure is being done,” said Dr. Anuj Kapadia, Sr. Consultant – Interventional Cardiology, AIG Hospitals.

The IMPELLA device which is known as “world’s smallest heart pump” was inserted into the heart through the groin artery under local anesthesia and helped in stabilizing heart function and ensuring blood flow to critical organs during procedure. It replicates the pumping function of the heart, providing blood flow of 3.5 liters/min. The overall procedure lasted for 3 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, Consultant – Interventional Cardiologist, AIG Hospitals.

The device was safely removed on table at the end of 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 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, AIG Hospitals.