Manipal Hospital Dhakuria, part of one of Eastern India’s largest healthcare networks, has successfully treated a 41-year-old patient with a rare combination of severe cardiac defects and an exceptionally challenging airway condition.
The patient, a businessman from Kharagpur, was diagnosed with severe aortic stenosis due to a congenital bicuspid aortic valve, along with a ventricular septal defect (VSD), a hole between the heart’s lower chambers. The case was further complicated by severe anxiety and an extremely restricted mouth opening of just one finger width, making conventional anaesthesia and airway management highly risky.
Given the potential for fatal complications from minor fluctuations in heart rate or blood pressure, the hospital’s cardiac surgery and anaesthesia teams devised a carefully coordinated plan. An advanced technique called awake nasal tracheal intubation was used to secure the patient’s airway. This method allowed the patient to remain conscious and breathe independently while the breathing tube was inserted through the nose, minimising cardiac stress and preventing airway compromise.
The intubation was successfully completed without any drop in oxygen levels or vital instability. This was followed by open-heart surgery during which the damaged aortic valve was replaced and the ventricular septal defect was repaired. The procedure was led by Dr. Kaushik Mukherjee, Consultant, Cardiothoracic Surgery, with anaesthesia support from Dr. Nilanjan Chakrabarty, Consultant Cardiac Anaesthesia.
Post-operative recovery was smooth, and the patient was discharged on the fourth day following surgery. He continues to improve under regular follow-up care.
The case demonstrates the hospital’s expertise in managing high-risk cardiac patients with complex conditions, combining advanced surgical and anaesthesia techniques with meticulous planning to achieve successful outcomes.
