27 year old software engineer survives a massive cardiac arrest

In an extra ordinary medical feat Wockhardt Hospitals,Bangalore – "A Network Hospital of Fortis, has set yet another benchmark in the history of medical science by performing a very complicated cardiac surgery on a 27 year old who suffered a massive heart attack.

Rupesh Mathur, a 27 year old engineer hailing from Bihar, complained of breathing difficulty and chest pain on 15th of November 2009 while on his way back home. As the pain increased his friends took him to a city hospital where he was diagnosed with heart attack and was initially treated with clot dissolving medicines. His family later shifted him to Wockhardt Hospitals.

“An angiogram showed severe blockage in 3 arteries. His heart was severely damaged and weakened. His life was in danger. We had to put him on an Intra-Aortic- Balloon-Pump (IABP), but he still had breathing difficulty. So he was put on a ventilator and special medication to stop clots from forming again. Surgery was the only option to save his life as his chances for survival was minimal even after surgery”, said Dr. N S Devananda, Cardiac Surgeon, Wockhardt Hospitals,Bangalore – A Network of Fortis.

“It was a big decision for his family to make him undergo surgery with less than 5% chance of survival. But his parents decided to go ahead” he added.

Rupesh underwent bypass surgery with the assistance of heart and lung machine to maintain blood circulation. Post the surgery his heart was extremely weak (Pulmonary Adema) and was not coping and he was on the verge of death, hence the doctors could not take him off the heart and lung machine.

Later the doctors decided to place him on an extra carboniam membrane operation (ECMO) and he was shifted to the ICU for 24 hours. ECMO treatment provides oxygenation until the patients lung function has sufficiently recovered to maintain appropriate O2 saturation.

It is often a last resort. Rupesh’s lungs had weakened due to poor circulation of oxygen. Keeping him on ECMO was a major challenge as his chest had to be open and his blood needed to be thin, which lead to bleeding. After 24 hours doctors tried to take him off the bypass however they were forced to put him back on circulatory support after just 45 minutes as his heart could not cope. The situation was extremely grim and doctors had left with two options 1) to keep him on life support system for further 24 hours and hope that his heart strengthens 2) A heart transplant, which was next to impossible to get a donor heart on such short notice.

On 22nd of November 2009 Rupesh was taken off circulatory system for 4 hours with his chest still open, but his heart was still too weak. Doctors put him back on circulatory support for another 12 hours after which his heart started strengthening and he was removed from the machine. 4 days later he was removed from the IABB and 9 days later he was taken off the ventilator. His heart recovered well and was discharged after 2 weeks.

Dr. Devananda said “I have never come across such a difficult case in my entire career. This is miracle, where a patient who was on mechanical life support for survival for so long recovering to live a normal life. This is truly a victory for modern technology and the never say die attitude of this 27 year old”.

These days’ young people are not immune to heart diseases and when it happens in younger people it is sudden, severe and caused more damage to the heart. Of late there is an alarming increase in the number of youngsters with heart diseases.