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Tezzbuzz Desk – Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital in Delhi have achieved a major milestone in the field of cardiac surgery. According to the institute, the world’s first robotic left atrioventricular (systemic AV) valve replacement was successfully performed on an adult patient. The patient suffered from two extremely rare congenital heart conditions, making the surgery extremely complex.

The operation was performed by a team from the Department of Cardiothoracic and Vascular Surgery (CTVS) under the supervision of Dr. Kavita Sharma, Director of VMMC and Safdarjung Hospital. The patient had been diagnosed with congenitally corrected transposition of the great arteries (ccTGA) and dextrocardia since birth.

The patient was suffering from two rare diseases.

The patient’s condition was significantly different from that of normal heart patients. ccTGA is a rare congenital heart defect in which the structure of the heart’s lower chambers and their associated blood vessels differs from normal conditions. This causes the right ventricle to act as the systemic ventricle, pumping blood throughout the body.

The patient also had dextrocardia. In this condition, the heart is located on the right side of the chest instead of the normal left. Both of these conditions significantly complicated the patient’s heart structure.

Over time, the patient’s systemic AV valve developed a severe leak. This was affecting heart function and increasing the risk of heart failure.

The surgical team faced a significant challenge.

This complex operation was performed by a team of expert doctors led by Professor (Dr.) Anubhav Gupta, Head and Director of the CTVS Department.

Due to the patient’s abnormal heart structure, performing the operation using conventional methods was challenging. To plan the surgery, doctors first performed a detailed 3D reconstruction of the heart using a CT scan. This helped the team understand the patient’s heart structure and develop a strategy for robotic surgery.

Robotic surgery performed from the left side, not the right.

The most unique feature of this operation was its surgical approach. Typically, robotic mitral valve surgery is performed from the right side of the chest. However, due to the patient’s dextrocardia, his heart was on the right side.

In this situation, doctors modified the standard technique and decided to perform the robotic surgery from the left side of the chest. The team developed a unique method for using the robotic system based on the patient’s inverted heart structure.

According to the hospital, this is the first time in medical literature that such a left-sided robotic approach has been used for systemic AV valve replacement in a ccTGA patient with dextrocardia.

Operation performed without cutting the chest bone

Another significant feature of this surgery was that there was no need to cut the patient’s breastbone, the main bone of the chest. Doctors inserted the robotic instruments into the body through small ports.

High-definition 3D visualization and highly precise robotic arms were used during the surgery. This allowed surgeons to operate with extreme precision within the patient’s abnormal chest cavity and heart structure.

What are the benefits of robotic technology to the patient?

This minimally invasive technique offers several potential advantages to the patient compared to traditional open-heart surgery. It eliminates the need for cutting the chest bone, thereby preserving the chest wall. Furthermore, the risk of blood loss and infection may be reduced.

Due to the smaller incisions, post-operative pain may be relatively less and the patient may recover faster.

A major achievement for Indian public healthcare

VMMC and Safdarjung Hospital have described this surgery as a significant achievement in the field of advanced robotic cardiac surgery. The institutes say that this operation demonstrates the modern technology and expertise available in the Indian public healthcare system on a global scale.

With this success, VMMC and Safdarjung Hospital have opened new possibilities for the use of robotic technology in the treatment of complex congenital heart diseases. According to the institute, this achievement demonstrates that Indian government hospitals can also set a new precedent globally in the field of advanced and complex robotic cardiac surgery.