Manipal Hospitals Bangalore Successfully Performed India's First Bentall Operation

Manipal Hospitals Bangalore, the foremost multi-specialty healthcare provider committed to clinical excellence and patient care, performed Bentall operation successfully on a Jehovah witness patient - 43-year-old Mr. Uwen from Nigeria - this month, a first in Asia.

A team of Cardiothoracic Vascular and Heart Transplant Surgeons, Dr. Devananda NS, HOD & Consultant - Cardiothoracic Vascular Surgery and Heart Transplant, Dr. Murali Krishna, Consultant - Cardiothoracic Vascular Surgery and Heart Transplant and Dr. Lalchand H Bandagi, Consultant Cardiothoracic Vascular Surgery and Heart Transplant of Manipal Hospitals Bangalore conducted this procedure.

Mr. Uwen, 43-year-old Geophysicist from Nigeria was excessively getting tired due to physical exertion for last couple of years. It worsened so much over the last two years that he had to voluntarily quit his job. When investigated, he was found to have severe leakage of aortic valve (one of the main valve of the heart) leading to severe enlargement of his heart, producing heart failure. He was put on heart failure medication and asked to undergo change of the aortic valve at the earliest.

Being a person of the Jehovah faith, who does not accept any blood or blood product transfusion, it was difficult for him to find a surgeon who would accept him for surgery. When he got in touch with the Jehovah community in India, he was directed to Dr. Devananda NS, HOD & Consultant - Cardiothoracic Vascular Surgery and Heart Transplant, and Manipal Hospitals Bangalore who have experience in treating several Jehovah patients for heart surgery.

Sharing more details on the case, Dr. Devananda NS, HOD & Consultant - Cardiothoracic Vascular Surgery, Heart Transplant, Manipal Hospitals Bangalore, said, "Mr. Uwen was reinvestigated at Manipal Hospital.

In addition to aortic valve leak with heart enlargement, he was also found to have gross enlargement of the aortic root and early part of his aorta, medically called 'annuloaortic ectasia'.

This condition requires not only the replacement of the aortic valve but also the replacement of the entire aortic root (Bentall Operation). This is a complicated operation and doing it without blood on the face of his poorly functioning heart (Ejection Fraction - 35%) which otherwise should have been 55% (in a normal person) was a challenge. After coronary angiography, he was treated for 2 weeks with iron replacement and erythropoietin injections to build his hemoglobin from 13.5 gm/dL to 14 gm/dL. He underwent Bentall Operation on 03/01/2020; he had a smooth recovery and was discharged within 10 days with a hemoglobin of 10 gm/dL."

To our knowledge, this happens to be the first case being reported from a Jehovah Witness in India. However, Dr. Devananda NS, HOD & Consultant - Cardiothoracic Vascular Surgery and Heart Transplant, Manipal Hospitals Bangalore, who has performed heart surgeries in over a dozen of Jehovah patients from 3.5 kg child to adults, says, "This is the second time he has performed this operation on a Jehovah patient. Apart from meticulous planning, the operation, good post-operative care is essential for successfully treating this challenging group of patients."

Expressing his happiness on the treatment, Mr. Uwen said, "I have recovered completely and now leading a happy and normal life all thanks to Dr. Devananda and team. The doctors have been supportive throughout the procedure and even my post-surgery follow-ups reports are good.

Grateful to the team that they took up this challenging surgery and at the same time keeping up with the sentiments of my belief and faith. I appreciate the efforts and commitment of the doctors."