A mild respiratory infection which would have taken a usual course for recovery took a fatal turn in the case of 29-year-old Rabeea Majhool, barely weeks before his nikah, back in Iraq. The infection spread from his lungs to his heart and within a fortnight of contracting the disease, Majhool was diagnosed with severe left ventricular dysfunction and doctors back home told him that without a heart transplant there was no hope.
With an extremely poor rate of cadaver donations internationally, Majhool would have never made it to the list of awaiting recipients despite having the best technology available in healthcare. The Human Organ Transplant Law in India allows a foreign patient to receive a cadaveric organ only once the national list is exhausted.
Setting a landmark in cardiac surgery, for the first time in North India, Doctors at Fortis Memorial Research Institute (FMRI), Gurgaon successfully implanted a FDA approved Mechanical Heart (a type of Left Ventricular Assist Device – LVAD) in 29-year-old Majhool, giving him a new lease of life. The patient required multiple hospital admissions during this period.
Called the Heart Mate II, the device was implanted through a complex procedure performed by Dr Sandeep Attawar, Director and HOD, Cardio Thoracic Vascular Surgery (CTVS) unit at FMRI assisted by Dr Prabhat Dutta, Head of Cardiac Anesthesia and his team last week. This makes Heart Mate II, the third mechanical heart to be implanted in India, the first two being at Fortis Malar in Chennai.
According to Dr Ashok Seth, Chairman, Fortis Escorts Heart Institute (FEHI) and Cardiology Council, Fortis Group of Hospitals, The surgery opens new avenues for not only Indian but also International patients awaiting heart transplants. This is definitely a momentous step towards continuity of life of patients awaiting heart transplants, given the sporadic rate of organ donation in our country. Delhi pioneered the first heart transplant, yet the southern states have developed a far better coordinated mechanism for organ donations and transplants. Innovative use of technology, such as this, will help in bridging the demand and supply gap in Delhi-NCR.
Explained Dr Sandeep Attawar, This is currently the most sophisticated technology and the only FDA approved technology available in the world and a permanent solution to Heart Failure and acts as destination therapy for a patient who cannot find a donor heart or in patient where heart transplant is not possible. Post this procedure, there is a 90% survival rate extending their lives for upto 10 years as against the survival rate in heart transplant patients which is estimated at only 50% upto 10 years. The device performs the function of the left ventricle of the heart and pumps the blood when the heart is too weak to do so, on its own.
Added Dr Dilpreet Brar, Regional Director, FMRI, Since its launch, FMRI has been at the forefront of several innovations. Today we are yet again proud to bring a new generation of advancement to our patients for treating cardiac disorders. This technology has wide spread utility as a life saver. With the evident advantage of not having to wait for a suitable donor, this implant procedure has the potential for widespread application in our country. It also reaffirms our commitment to evolve lifesaving cardiac surgery at our hospital.
There are many advantages of implanting a mechanical heart. Unlike a heart transplant which requires intake of immuno-suppressants to facilitate organ acceptance, patients with implanted device need to take only one simple blood thinning medicine to ensure free flow of blood. This also prevents the high risk of contracting infection post-surgery. Another noteworthy advantage is that the device can be removed if the left ventricle recovers in due course of time. Furthermore, patient with rare blood groups can also benefit from the implant as same device is inter-operable with all blood groupings. As the technology matures and the devices become miniaturized, future devices can be completely implanted inside the human body with an internally placed long-term energy source, allowing even greater convenience and ease to patients.
As per FDA certification, the expected longevity of the device is 60 years and hence an effective long-term solution for those who would never be eligible candidates for a heart transplant. The burden of heart failure in India is high, roughly estimated close to 5 million and due to lack of availability of deceased donor hearts the problem is even more insurmountable in current scenario. The LVAD therapy is the next big hope for the patients suffering from heart failure who are either elderly, children in the age group of 12-14 years suffering from dilated cardiomyopathy, cancer patients, those suffering from immuno-deficiency syndrome, or afflicted with viral infections of the heart to prolong their life while allowing them to lead a life as close to normal as possible.