Aortic Valve Replacement in Critical Aortic Stenosis with Congestive Heart Failure
- drpavankumar
- 0
- on Apr 20, 2019
Aortic Valve Replacement in Critical Aortic Stenosis with Congestive Heart Failure
Mr. Ashok 28 yr Old had defective Aortic Valve since birth ( Bicuspid Aortic Valve), which gradually narrowed & calcified by age of 25 yrs this Aortic Valve became critically narrowed with Aortic Valve area of less than 1 cm2 . Due to unavailability of financial help , he delayed the required heart operation. This delay resulted in heart failure with fluid accumulation in lungs, abdomen & enlargement of Liver & Poor renal / kidney function. His Echo cardiography showed very poor heart function of < 25% & failing right sided chambers.
Treatment – He was admitted in ICU & started off with aggressive decongestive treatment . After 7 days this treatment , his liver, kidneys, & lungs started functioning better. He was then taken up for Aortic valve replacement heart surgery in first week of April in BSES Hospital, Mumbai by Dr. Pavan Kumar , the Senior Heart Surgeon.
AVR ( Aortic Valve Replacement ) heart surgery was successful & patient did very well & discharged on 7th post operative day.
Discussion – Critical Aortic Stenosis with congestive Heart Failure is very serious complication with very high mortality. As heart chambers decompensate leading to multiorgan ( Kidney, liver, Lungs)Failure. This leads to untimely death to these group of patients. Heart operation in this situations remains highly risky. Adequate aggressive decongestive therapy with preconditioning of Myocardium before AVR can help in attaining successful outcome. Although it is a high risk operation but this must be offered to these patients of critical Aortic stenosis as this is a mechanical obstruction is removed by AVR , heart muscle recovers with recovery of other ( Lung, Liver, Kidney) organs like in this patient with surgeon’s expertise & good myocardial / liver / kidney / lung protection strategy this “ High Risk AVR in Heart Failure” can be operated successfully.