RML doctors perform unique cardiac op on patient with rare anatomy

New Delhi: In a remarkable medical achievement, doctors at Ram Manohar Lohia Hospital have recently performed what they claim as the world’s first minimally invasive cardiac surgery on a 31-year-old woman with an extremely rare and complex congenital condition.The patient, a mother of two, was diagnosed with partial atrioventricular canal defect, meaning there was an abnormal opening between the cardiac chambers near the heart valves since her birth. The situation was complicated further by ‘situs inversus totalis with dextrocardia’, whereby all her organs, including the heart, are arranged as a complete mirror image of normal anatomy — heart to the right side, liver to the left, stomach to the right, and so on. This condition complicates medical procedures, especially cardiac surgeries.So, instead of performing a traditional open-heart surgery, doctors opted for a minimally invasive approach, making a 4-cm incision below the breast. The patient was placed on a heart-lung machine, allowing surgeons to safely operate on the heart.They then repaired the defect using a patch made from her own pericardium, a sac that encloses the heart, carefully stitching it in place while avoiding critical structures like heart valves and the electrical conduction system, which controls heartbeat.The surgery was particularly challenging due to the reversed anatomy and the limited space for operating, requiring exceptional precision, the doctors said.“This was not just a structural defect, but a complete reversal of anatomy. The hole in the heart was between her two valves. The most delicate part involved stitching near the heart’s conduction system and atrioventricular valves without causing damage, making it truly unique,” said Dr Narender Singh Jhajhria, director professor and head of CTVS at Atal Bihari Vajpayee Institute of Medical Sciences and RML Hospital, who led the surgery. “It’s the world’s first minimally invasive atrioventricular canal defect repair in situs inversus dextrocardia,” he added.The procedure was supported by a multidisciplinary team. Dr Jasvinder Kaur Kohli, head of cardiac anaesthesia, managed anaesthesia and intraoperative monitoring, while senior perfusionist Jagdish Chandra handled the cardiopulmonary bypass.Calling it a “proud moment” for the institute, its director Dr Ashok Kumar said that the surgery demonstrates its capability to handle highly complex cardiac cases using advanced, less-invasive techniques.The patient has made a smooth recovery, with postoperative echocardiography confirming a successful repair. She has been discharged and is expected to return for a routine follow-up next week. Her entire treatment was covered free of cost under the Ayushman Bharat scheme.