Doctors at Fortis Memorial Research Institute (FMRI) in Gurugram recently gave a 21-year-old Iraqi woman another chance to live by conducting a rare surgery that connected her liver directly to the heart.
The patient suffered from a rare genetic condition in which blood clots prevented the blood flow in and out of the liver.
Doctors in Iran had diagnosed her with a rare genetic disorder called Budd Chiari Syndrome, a condition where blood clots completely or partially block the blood flow to the liver.
A team of doctors led by Vivek Vij, Director Liver Transplant at FMRI, conducted a complex lifesaving surgery in a carefully crafted procedure on December 28 last year.
"My parents sent me to India fearing relatives might say they did not try enough to save my life," said 21-year-old Bnar Satar Mala, who till December 2016 had given up hope of survival.
It all started in the year 2014, with initial symptoms of Mala turning pale, then yellow, with severe pain shooting down the left shoulder to her arm and soon developed into swelling in her limbs and abdomen.
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"I would feel nauseous at the mention of food, I could barely eat and often threw up soon after," Mala said.
By the time Mala reached FMRI, her liver was completely black and shrunken, requiring urgent transplant in order to save her life.
"Her 27-year-old brother, Bzar, matched for a donor. All necessary tests were done and she underwent the transplant on December 28," said Vij.
Mala's IVC was completely blocked and she required a lot of blood transfusion during the surgery.
The affected liver was removed and a part of the liver was taken from her brother and transplanted in the patient.
"In this case, the challenge was to suture the liver 'directly' to the heart as the patient's native IVC was completely blocked. In order to suture the liver as close to the heart as possible, the heart had to be pulled down into the abdominal cavity," Vij added.
The doctors decided not to open the recipient's chest and instead pulled the heart down through a narrow gap made in the diaphragm separating the chest and the abdomen.
"By doing this, we significantly reduced the risk of any infection which could have occurred due to a large opening in the chest. Also, being a woman, her concern was the scar such an opening would have left on her chest," Vij said.
"The hepatic vein was sutured directly to the heart through this novel technique and the team made sure that they did all this avoiding sternotomy (cutting open the chest to reach the heart)," he added.
Doctors worked meticulously post-surgery to maintain a fine titration of her medicines to make sure of optimum anti-coagulation, Vij said.
--IANS
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