Wednesday, August 29, 2012

Dr Kaushal Pandey, cardiovascular/thoracic surgeon at Fortis Hospital


Man with heart on the wrong side undergoes rare surgery

Doctors at Fortis say 67-year-old is only the 27th person in the world to undergo a bypass with his condition

When Mulund resident Ramesh Gopinath Goswami felt some pain in his chest last month, he went to get a routine test done, and left doctors at Fortis Hospital baffled by what they saw. His angiography reports showed multiple blockages in his three coronary arteries, but doctors struggled to identify what they were seeing.
 “We realised that the arteries that are normally on the left side were on his right, and vice versa,” said Dr Kaushal Pandey, cardiovascular/thoracic surgeon at Fortis. “The human heart is normally felt on the left side of the body, but in this case, we could feel it on the right side.”
Goswami, a 67-year-old Dharmacharya, suffers from a condition called dextrocardia- a congenital condition where the heart reversed.
“We decided we had to perform a bypass surgery, even though it was complicated,” said Dr Pandey. “Before conducting the surgery, however, we performed some other tests and were surprised when we realised that it wasn’t just his heart, but his entire body was a laterally inverted image of the normal human form (called sinus inversus). His appendix and liver were on the left side instead of the right and his spleen was on the right side instead of his left.”
Doctors said that incidences of dextrocardia with situs inversus occur only in 1 of around 30,000 cases. In such cases, there are high chances that the diagnosis can go wrong, if the doctor hasn’t identified the condition. Doctors said that since the heart is normally felt on the left side, ECG results can easily be wrong.

THE SURGERY

Even though the angiography report showed that coronary arteries were blocked, when doctors began the procedure, they were admittedly a little confused by what they saw. “Identifying major arteries are very important, but when you’re so used to seeing them a certain way, it can get very confusing,” said Dr Pandey. “I was standing on the right side of the operating table - where I normally stand - but had to shift to the other side to begin to identify the arteries correctly.
However, the surgery went off very smoothly after that.”
“I kept thinking that one little mistake can prove fatal,” added Dr Pandey.
Beena Daru, Goswami’s daughter said, “My father eats only sattvik food, and has never been diagnosed with a serious disease before in his life. We didn’t expect that he would have multiple blockages,” she said. “But we are very thankful that everything is alright.”
Goswami is recuperating after the surgery and will be discharged soon.

LATERALLY INVERTED BODIES

» Sinus Inversus, also known as oppositus, is a congenital condition where the major visceral organs are reversed or mirrored from their normal positions.
» It occurs in approximately 1 in 10,000 people, while dextrocardia with sunis inversus occurs in 1 in around 30,000 cases.
» In the absence of congenital heart defects, people can lead normal healthy lives, without complications related to their medical condition.
» Many notable people, including Canadian actress Catherine O'Hara, are known to suffer from the condition.

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