MUMBAI: A 75-year-old grandmother living in central Mumbai, Megha Khanna, never thought that a simple fall would turn into a life-threatening medical crisis. The operation to fix the right shoulder shattered in the fall could only be done after doctors fixed the multiple blockages in her arteries – all in a span of 10 hours.
On January 23, Khanna was taken to hospital with a shattered shoulder. Due to her age, a full checkup – including a troponin test and ECG scan to rule out heart problems — was advised as a precaution. However, the doctors found multiple blockages in the arteries, making her unfit for immediate shoulder surgery as there could be a high risk of heart complications during the surgery.
The medical team at Surana Sethia Hospital in Chembur then decided that the only viable option was to perform both surgeries at the same time. There were, of course, concerns over whether the patient’s heart would be able to handle the additional stress. The other option of delaying the shoulder surgery by six to eight weeks could leave her permanently disabled, while performing the surgery without repairing the patient’s heart condition could trigger some emergency. Moreover, as blood thinners are given to patients within hours of undergoing heart surgery, the second operation could face an additional risk of heavy bleeding.
Considering the various options, cardiac surgeon Dr Partha Sarathi and orthopedic surgeon Dr Kaustubh Durve decided that they had a small window of time to perform both surgeries at the same time with a slightly higher risk.
On January 27, the cardiac surgeon first conducted a beating-heart coronary artery bypass graft (CABG) surgery; this option reduces blood loss while providing the heart with the grafts that it requires to enhance its pumping ability. The four-hour procedure thus made it possible for the patient to undergo the second procedure safely. The orthopedic team took over immediately to reconstruct Khanna’s broken shoulder, setting it into the proper position and making it mobile. The operations lasted around 10 hours, all under the same anaesthesia. Khanna, meanwhile, is happy that she was mobile on the second day after surgery.
