Manipal Hospitals Bangalore performed a quadruple valve procedure for the first time in Karnataka to give new lease of life to a 38-year-old male patient. Dr. Devananda N S, HOD & Consultant - Cardiothoracic Vascular Surgery, Heart and Lung Transplant Surgery, Manipal Hospitals Old Airport Road, performed this path-breaking surgery amidst the pandemic. His surgery was performed in the holy month of Ramadan in the COVID season. What makes this case truly interesting is that this is the first patient in Karnataka to undergo an operation for all four valves simultaneously.

The patient, a resident of Kolar, Karnataka was suffering from sudden cardiac symptoms. He was struggling with his daily activities for the last two months and his condition was deteriorating day by day.

Dr. Devananda N S, HOD & Consultant - Cardiothoracic Vascular Surgery, Heart and Lung Transplant Surgery, Manipal Hospitals Old Airport Road, sharing his thoughts, said, "When this patient first came in, he was found to have an extremely unusual problem in a common disease, known as rheumatic heart disease. All the four valves of the heart had narrowed down significantly, medically known as stenosis. The overall function of the heart drops down significantly in such patients causing symptoms even at rest.''

Rheumatic heart disease is a common problem in developing countries like India. However, the condition generally affects only 1 or 2 valves in the majority of cases. Evidence suggests only about 1 in 4000-5000 patients with the condition have complications in all the 4 valves, as in this patient. The only option available for this patient to survive was undergoing surgery. The surgery itself was tricky and complex because he required replacement of 3 valves namely Tricuspid valve, Mitral valve, Aortic valve along either repair or replacement of the fourth valve i.e. Pulmonary valve.

Dr Devananda further added, "During the holy month of Ramadan, he was in fasting and the COVID lockdown made surgery itself a questionable solution and put us into an uncomfortable situation. It was important for us to rule out COVID-19 to ensure the safety of the patient and the hospital in these testing times. After consulting with the patient, we went ahead with the surgery. He had 3 valves replaced with mechanical valves because of his young age and the pulmonary was repaired. Overall, the surgery and post-operative care went smooth and he got discharged by the 9th day post-surgery."

After a month of follow-ups, the patient was found to recover very well, with no symptoms at all. His dependency on medicines was also reported to come down as compared to previous times.

One of the key challenges during surgery was the need for blood. With COVID-19, there is a constant fear among blood donors and hence there was a sharp decline in its availability. "But we had to perform the surgery," said Dr. Devananda. The patient's friends and family came forward in this dire hour of need to help donate blood so that the surgery could be performed smoothly.

"We are happy to see such good results in a rare case. It motivates and challenges us, especially during a pandemic. The fear of COVID should not refrain patients to visit Hospitals especially those who are seeking consultation on critical medical issues," added Dr. Devananda.

The COVID 19 and its hurdles are an additional motivator for such doctors and hospitals to continue to extend their service and help people in need.

Manipal Hospitals Old Airport Road is undertaking maximum safety and sanitization precautions meeting global standards to avoid the risk of infections during your stay. Immediate medical care is the key to survival in patients with underlying heart disease. With no immediate respite from the pandemic insight, we request to all ailing patients not to delay treatment any further to prevent life-threatening consequences