CABG with Mitral Valve Repair in Elderly Patient

(An Ejection Fraction <20% with associated Hodgkins Lymphoma & Diabetes Mellitus) by

Dr. Baldev Singh Sekhon, MD

Dr. Baldev Singh Sekhon operated upon a patient suffering from Coronary Artery Disease with an ejection fraction of less than 20%.The surgery done was a Coronary Artery Bypass Graft Surgery along with a Mitral Valve annuloplasty. According to Dr. Baldev Singh Sekhon, the surgery fell under the category of a high risk surgery considering the various parameters such as the patients age, ejection fraction and past medical history. Mr. Birender Singh Yadav aged 60 retired from the Indian Armed Forces. He led a healthy life until he was diagnosed with Coronay Artery Disease and Tricuspid Valve Dysplasia for which he was treated with an angiography twice, once in the year 2011 and then 2012. A few months later he was diagnosed with left ventricular dysfunction which started getting worse. He suffered from frequent bouts of breathlessness and tiredness. Apart from these he was a known case of Diabetes mellitus and Hodgkins Lymphoma. The patient ever since was looking for treatment options and seeking opinions from various CTVS surgeons from all over the country. He visited many hospitals but was turned down stating that it was a high risk surgery with very low chances of success. Having being turned down from surgeons, one day he met a close friend of his Dr. B.K Singh, an orthopaedician who mentioned about Dr. Baldev Singh Sekhon, a U.S board certified CTVS surgeon, heading the Dept of Cardiothoracic surgery of a premier hospital in NCR. Dr. Baldev Sekhon had returned to India from Cleveland, U.S after a 30 year long stint. When Mr. Birender Singh met Dr. Baldev Singh Sekhon, he had sessions where he discussed the pros and cons of the treatment options available to him. Finally, Dr. Baldev Sekhon gave him a proposition where he could go ahead with a CABG and mitral valve repair and that there was still hope! According to Mr. Birender, his following appointments with Dr. Baldev Sekhon were encouraging and ensured that the surgery could give positive results. He was convinced with the option given to him and felt that it was justified to give Dr. Baldev Singh a chance. Birender trusted Dr. Baldev Singh Sekhon. The surgery was performed when Birender Singh was brought to the hospital in emergency with complains of breathlessness. The patient was wheeled in the OT with Dr. Baldev Singh Sekhon by his side. According to Dr. Baldev Singh Sekhon, this was a high-risk surgery as Mr. Birender Singh was an elderly patient and had a history of previous cardiac procedures done (Angiography, Angioplasty). Also, Dr. Baldev investigated and found that the patients E.F (volumetric fraction of blood that is pumped out when the heart contracts) was 20%.This as per Dr. Baldev Singh Sekhon, M.D was most challenging aspect. Also diseases like Diabetes and Hodgkins Lymphoma affected the bodys defence and healing mechanism. Therefore, the possible complications had to be anticipated by Dr. Baldev Sekhon well in advance to ensure a successful outcome.

On 17.01.2013, Dr. Baldev Singh Sekhon conducted the surgery for Birender Singh. The surgery was a coronary artery bypass graft in which 4 arteries were involved and a mitral valve annuloplasty with a 32- complete,rigid ring. After the surgery, Mr. Birender was moved to the intensive care unit for monitoring. Approximately after 48 hrs he was moved to the room. Overall, his recovery phase in the hospital was uneventful. The patient was glad to have met Dr. Baldev Singh Sekhon and was happy that he chose to get the surgey done. According to Mrs. Birender Singh, Their eyes were twinkling when they came out of the OT. They told me, Mrs. Yadav we saved your husband and that is because of his confidence and will power. He was happy and the doctor held my hand and I said thank you doctor, I had full confidence in you and your team. It is a miracle.