An unusual feat
In 2016, when 52-year-old Ahmed (name changed) left Hyderabad for Ajmer Sharif on a pilgrimage, little did he expect to find out he has a twisted heart, literally! Mesocardia is a condition wherein the placement of the heart is reversed in the rib cage, making the access to the aorta and atrium extremely difficult. Ahmed’s condition was diagnosed after he suffered a heart attack in Ajmer.
When local doctors realised the condition of the patient, he was immediately sent to Mumbai, from where he was sent to Hyderabad. Finally, Dr Prateek Bhatnagar, the chief cardiac surgeon in one of Hyderabad’s private hospital, performed the ‘beating heart surgery’ on Ahmed.
Dr Bhatnagar completed his MBBS as the best student from Kanpur Medical College with 10 gold medals to his name. In 2007, he was declared one of the most outstanding graduates of GSVM Medical College, Kanpur, and has performed over 10,000 cardiac surgeries till date.
A complex process
A condition that affects two out of one lakh people, mesocardia is fairly hard to detect until the person faces any other health issue because of which he or she may have to undergo a CT Scan, 2D echo or a chest X-Ray. Explaining the complex surgery, Dr Bhatnagar says, “Once mesocardia was confirmed with the cardiac apex pointing to the centre we decided to operate on the patient with a Y-grafting on the beating heart, instead of an open heart surgery. Which means we did not connect the heart to a heart-lung bypass machine. This machine usually removes the blood away from the heart so that the surgeon can operate. Instead, we operated on the beating heart itself.”
For Dr Bhatnagar, the biggest roadblock was that no medical literature was available regarding bypass surgery in the case of mesocardia. He says, “I consulted with many of my contemporaries before deciding to operate on Ahmed the way I did. But it was important to document this surgery as future reference for doctors who might come across similar cases. But mere documentation of the surgical process was not enough. We had to prove that the patient took well to the procedure and is leading a normal life.” Now, two years later, Ahmed is perfectly healthy. His case will be recorded as the world’s first successful bypass surgery done on a twisted heart in the July edition of Annals of Thoracic Surgery.