~The patient was suffering from a ventricular septal defect, since childhood, and lack of awareness and timely treatment led to Eisenmenger’s syndrome
~Combined Heart and Lung Transplant was the only treatment option available for the youngster
A 24 year old girl suffering from a rare and complex congenital heart disease recently underwent a combined heart and lung transplant at Global Hospital, Mumbai. Akshara (name changed), a resident of Mumbai, had been suffering from a ventricular septal defect since childhood which progressed over the years leading to Eisenmenger’s syndrome.
Although she was managed medically for a very long time, her condition worsened of late, and as a result, she had to be put on home-based oxygen therapy. The 24-year-old underwent a combined heart and lung transplant in the month of June 2019 and is recovering well.
The burden of patients with inoperable adult congenital heart disease and secondary pulmonary hypertension in this country is overwhelming. These individuals have a condition called Eisenmengers syndrome. Many of them continue to turn deeply blue over time and develop secondary complications like cerebral strokes, severe right heart failure, infective endocarditis and die painful deaths after suffering immeasurably.
Dr Sandeep Attawar, Director and Chair of the Heart and Lung Program, Gleneagles Global Hospitals said, “The individuals who have Eisenmengers syndrome could have undergone corrective heart surgery in their infancy or childhood that would have prevented this fate.
However, it is only of recent that these facilities have been more common place in this country. So, these individuals that missed the bus, now are condemned to a pathetic existence unless an option such as the replacement of these seriously damaged organs is considered or feasible.”
“However, for the replacement of the seriously damaged organs, there has to be an increase in deceased organ donation,” stated Dr Sandeep. He also mentioned that there is an uptick in awareness on organ donation and a ray of hope for individuals with this advanced and medically untreatable heart disease.
“The final solution for Eisenmengers syndrome is a heart and double lung transplantation. Akshara is one such young girl who had ventricular septal defect that wasn’t operated upon in her childhood. Heart-lung transplantation is the simultaneous surgical replacement of the heart and lungs in patients having end-stage cardiac and pulmonary disease. It is a viable treatment option,” mentioned Dr Attawar. Patients who are chosen for the heart and lung transplantation are selected carefully after a series of coordinated and properly sequenced steps. As per The International Society for Heart and Lung Transplantation, the indications for heart and lung transplant are congenital heart disease with Eisenmenger syndrome followed by idiopathic primary pulmonary hypertension with terminal right heart failure and cystic fibrosis with severe right heart dysfunction.
Akshara’s transplant lasted for 6 to 7 hours. Post-surgery she was rehabilitated and was subsequently discharged in mid-July. She has been regularly following up with the clinical team and is recuperating well. Her follow up lung biopsies and levels of immunosuppressive medications are being monitored closely and treated under close medical supervision.
Dr Vivek Talaulikar, Chief Executive Officer, Global Hospital said, “I would like to thank our team of doctors for the tremendous effort that they have invested to give Akshara a new lease of life. Till date, Global Hospital, Mumbai, has successfully carried out three bilateral lung transplants, and 1 combined heart and bilateral lung transplant. Our program will offer a safe and caring atmosphere for all patients like all our other organ transplant programs running for decades across India.”
“I would specially thank the donor family who have taken up a brave cause of donating the organs of their loved ones. Today as you see, organ donation has given a new life for this youngster. I would appeal to the communities via the media to come forward and pledge for organ donation,” added Dr Vivek.
