Doctors at BGS Gleneagles Global Hospital, Bengaluru conduct state’s first simultaneous double lung transplant and coronary artery bypass grafting surgery (CABG). In the past most people with coronary heart disease (heart blocks) weren’t considered candidates for a lung Transplantation. These complex surgeries were hitherto undertaken only by expert teams at highly equipped medical facilities abroad. It is an extremely critical procedure to combine lung transplantation with coronary artery bypass surgery (CABG) as the risks involved are numerous.
Mr Ishaq Abdel Hakim Ahmad Sharawi, a 61 year old gentleman from Jordan, was diagnosed with advanced interstitial lung disease with both lungs permanently fibrosed and damaged. He was completely wheelchair bound and dependent on 10 liters of oxygen per minute 24/7. He was evaluated for lung Transplantation but tests showed 2 major blocks in his heart blood vessels. Since he was deteriorating fast the team led by eminent heart and lung transplant surgeon, Dr Sandeep Attawar decided to undertake combined lung transplant with heart bypass surgery. He was medically optimized by a team consisting of heart failure cardiologists Dr Ravi kumar, Dr Arul Narayan and Transplant Pulmonologists Dr Vijil Rahulan, Dr Apar Jindal and Dr Sandeepa HS. Preoperative cardiopulmonary rehabilitation and dietary optimization was done to prepare him for this complex and long surgery.
The lung transplant surgery was done with the help of a cardiopulmonary bypass machine. After the Transplant was completed, a vein graft was harvested from the patient’s leg and a coronary artery bypass surgery was done to bypass the 2 heart blocks he had. The entire surgery lasted five and a half hours. A team of cardiothoracic and vascular (CTVS) surgeons including Dr Govini Balasubramani, Dr Bhasakar B V and Dr Madhusudana assisted Dr Attawar in this complex surgery. Anesthesia and Intensive care was provided by renowned cardiac anesthetist Dr Prabhat Dutta, supported by Dr Anoop Mohandas and Dr ShivaPrakash.
The patient is recovering well. He was taken of the ventilator after 24 hours and mobilized in the second day post-surgery. Commenting on the case, Dr Sandeep Attawar, Program Director and Chair, Cardiac Surgeries and Thoracic Organ Transplant, Gleneagles Global Hospitals said, “At most hospitals, the presence of associated cardiac disease during lung transplantation requires two separate surgical teams: a thoracic surgeon for the lung and a cardiac surgeon for the heart. Given the unpredictable nature and timing of transplantation, this can pose a logistical challenge, which prompts many centers to turn down such patients. At our hospital, we have a multi-disciplinary team of thoracic and cardiac surgeons performing lung transplantation, which gives us the versatility to offer combined surgeries to patients. This versatility, together with cardiac surgery and lung transplant volumes that are among the very highest in India, makes our team distinctively well prepared to offer surgery to patients with complex conditions such as this who have no options other than this.”
Dr Vijil Rahulan, Chief Transplant Pulmonologist, Gleneagles Global Hospitals added, “Lung transplant is the only option for end stage lung diseases like Interstitial lung disease (ILD), Chronic Obstructive Pulmonary Disease (COPD), Pulmonary hypertension. A lung transplant can dramatically improve quality of life and increased survival. For patients with end staged lung disease with coronary heart problem, this option of combined lung transplant with CABG is much better than a heart and lung transplant as it provides a much better long term survival.”
The heart lung transplant team led by Dr Sandeep Attawar has the best record of experience in lung Transplantation in India with 70 Lung transplants done since April 2017. They have also completed 59 heart transplants making them leaders in heart and lung transplantation in the country. This includes 6 successful lung transplants at BGS Gleneagles Global Hospital in Bangalore. A third center for transplantation has also recently started in Global Hospitals Mumbai to cater to increasing transplantation needs in India.
Ms Shailaja Suresh, CEO, Gleneagles Global Hospitals, Bengaluru concluded, “This is the first successful combined bilateral lung transplantation and cardiac bypass surgery in Karnataka; a milestone achievement that will pave the way for many more successful and innovative procedures. BGS Gleneagles Global Hospital has successfully attempted and completed a number of complicated procedures in the past year, making it a centre of choice for people with end-stage lung conditions. Since the launch of the programme in July 2018, our lung transplant specialists carried out 7 successful bilateral lung transplants.”
This is the team’s 3rd combined lung Transplant and CABG, but the first done in Karnataka. The team is also credited with giving second Life to Mr Raghuveer, the first Kannadiga to receive combined heart and double lung transplant back in November 2018. Luckily, a matching Donor became available on 20 February at Sparsh hospital. Lung transplant Retrieval team led by cardiothoracic surgeon, Dr Bhaskar B.V was sent to Sparsh hospital and the organ was transported to BGS Gleneagles Global Hospital in record time of 20 minutes with the help of a green corridor set up by traffic police.