Timely intervention saves life of HCM City patient with cardiac arrest
Doctors at the HCM City-based Gia Định People’s Hospital have successfully saved the life of a 52-year-old patient who suffered a sudden cardiac arrest and stopped breathing.
HCM CITY — Doctors at the HCM City-based Gia Định People’s Hospital have successfully saved the life of a 52-year-old patient who suffered a sudden cardiac arrest and stopped breathing.
Bùi Minh Thành, head of the hospital’s Cardiac Surgery Department, said the department was able to save the patient from Hóc Môn District, who suffered from severe chest pain when he arrived at the hospital.
The patient underwent a coronary angiography with a diagnosis of myocardial infarction due to complete occlusion of the right coronary artery, while the remaining two main branches had 90-95 per cent stenosis.
The patient was diagnosed with heart failure on the basis of underlying medical conditions such as hypertension, diabetes, chronic kidney disease, gout, and lower extremity venous insufficiency. Along with medical treatment, the doctors consulted and assigned the patient to have coronary artery bypass surgery.
On November 2, the patient’s surgery was performed. The anesthetic process went smoothly, and he was hemodynamically stable.
However, after the team took a vein in the patient's leg to make a bridge, suddenly his blood pressure dropped rapidly and he fell into cardiac arrest. Although the team had massaged the heart outside the chest and injected adrenaline, the heart did not respond.
The doctors decided to amputate the sternum, open the chest, and open the pericardium to massage the heart directly. Doctor Thành said the patient’s heart was enlarged with a lot of blood in the pericardial cavity. The surgical team quickly implemented extracorporeal circulation to prevent the risk of cerebral ischemia and visceral ischemia.
After running extracorporeal circulation, the patient’s heart fell into a state of direct electric shock, right ventricular fibrillation and atrial fibrillation. At the same time, the patient had dilated pupils, and the risk of death was very high. Doctors examined the the right ventricle of the heart and found that the ruptured site was about 2.5cm long with blood rushing with the heartbeat.
Immediately, the suture team closed the ruptured area of the heart and performed three bypasses on the blocked and narrowed coronary arteries to reperfuse the heart muscle. After coronary bypass, the doctor implemented a pacemaker, and continuous heart massage with high-dose vasopressors. The heart beat again after 12-15 minutes.
“After 36 hours of resuscitation, the patient was extubated, breathing on his own, moving his limbs, and gradually recovering his memory,” Thành said.
Myocardial infarction causing heart failure complications can occur in 5-10 per cent of acute myocardial infarction cases about two weeks after the infarction, causing sudden death.
“This heart case was an unexpected situation in the operating room and was also a lucky factor that can save a patient’s life,” he said.
Currently, the patient is in a stable condition after surgery, and is expected to be discharged from the hospital soon. — VNS