Kolkata, Medical doctors at a Kolkata hospital have efficiently implanted a everlasting pacemaker in a 62-year-old lady with a synthetic bicaval valve system, a uncommon anatomical situation “reported solely as soon as earlier than” in world medical literature.
Authorities on the Manipal Hospital within the metropolis’s Mukundapur space claimed that this was the primary such case within the nation, and solely the second worldwide.
Dr Soumya Patra, Senior Marketing consultant of Cardiology and Director of the Cath Lab on the hospital, led the process final month with assist from Dr Subhasish Deb and different workforce members.
The affected person, Shyamali Biswas, a homemaker from Sonarpur in South 24 Parganas district, had an extended historical past of extreme coronary heart illness, he mentioned. In 2023, she underwent tricuspid valve alternative surgical procedure in Vellore, after her pure valve was extensively broken, Patra mentioned.
Owing to superior coronary heart failure, she obtained a synthetic bicaval valve system, wherein valves have been positioned in each the superior and inferior vena cava, as a substitute of a standard valve restore, he mentioned.
Earlier this yr, she developed full coronary heart block, a severe situation wherein defective electrical alerts trigger the center to beat abnormally slowly, and was admitted to the hospital on February 2. Medical doctors suggested pressing implantation of a everlasting pacemaker.
Nonetheless, the presence of a synthetic valve within the superior vena cava , one of many fundamental veins returning blood to the center, posed a big problem, as pacemaker leads sometimes go by way of these veins to succeed in the center, in response to the physician.
Patra mentioned the synthetic bicaval valve system “fully adjustments the conventional anatomy of the center”.
“The superior vena cava valve makes lead placement significantly troublesome. Pacemaker implantation within the presence of an SVC valve wants precision and thorough planning, as even minor misplacement can harm the valve or compromise blood movement. It could result in troublesome pacemaker lead negotiation and placement,” he mentioned.
Whereas leadless and epicardial pacemaker implantation have been various choices, the previous is dearer and the latter requires surgical assist, he mentioned.
“On this case, we adopted a method that allowed profitable placement of a standard pacemaker regardless of the anatomical issue created by the caval valve. It is very important point out and be taught from such technological variations, as they can assist others handle related complicated situations,” Patra mentioned.
He mentioned long-term follow-up, together with common pacemaker programming and echocardiography at periodic intervals, can be required.
Shyamali’s daughter Nabamita advised PTI that the household was extraordinarily anxious about her well being situation, particularly since she had already undergone a serious coronary heart surgical procedure in 2023.
“My mom is at present on BiP assist and beneath common medical follow-up, and we’re hopeful she’s going to return to regular life very quickly,” she mentioned.
Sufferers with synthetic tricuspid valves who later require pacemaker implantation are extraordinarily uncommon. The profitable intervention marks a big milestone in superior cardiac care, officers mentioned.
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