The patient had undergone a palliative bidirectional Glenn procedure in 2004 and continued periodic follow-ups. (Representative Image)
But within hours, the 26-year-old, who had lived with a complex congenital heart condition since childhood, suffered a sudden cardiac arrest and had to be revived by doctors. Doctors said such complex single-ventricle conditions account for less than 5% of congenital heart disease cases. We therefore decided to use a subcutaneous ICD, in which the entire system remains outside the heart and blood vessels, avoiding this risk,” said Dr Anand Shenoy, consultant, interventional cardiology, Manipal Hospital Old Airport Road.
Further evaluation revealed severe dysfunction of his only functioning heart chamber, prompting doctors to implant a specialised defibrillator to protect him from another potentially fatal cardiac arrest.
Dr Darshan Krishnappa, lead consultant, cardiac electrophysiology, said patients with severely reduced pumping capacity are at higher risk of sudden cardiac arrest and that an ICD can help detect and treat dangerous heart rhythms in appropriately selected patients. Doctors said the case highlights the challenges of managing patients with complex congenital heart disease into adulthood, particularly those with single-ventricle physiology, and the need to tailor treatment to their individual cardiac anatomy. BENGALURU: Ajay (name changed) had walked into a Bengaluru hospital for evaluation of a health complaint. The patient, who has been under regular cardiac follow-up for years, has a rare form of congenital heart disease with single-ventricle physiology. In his case, the right ventricle is severely underdeveloped, leaving the left ventricle as the main functioning pumping chamber. A few days ago, he presented to the outpatient department of Manipal Hospital, Old Airport Road, for evaluation of an unrelated symptom. “In a patient with a single ventricle, implanting a lead inside the heart carries a high risk of stroke. The patient successfully underwent S-ICD implantation and was discharged in a stable condition. Given the severity of his underlying heart condition and ventricular dysfunction, he is now being evaluated for a heart transplant.