Two Heart Valves Replaced Immediately After Caesarean Delivery, Saving Mother and Newborn
SGPGIMS performs Uttar Pradesh's first and India's fourth such combined life-saving procedure
Lucknow: Doctors at Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, successfully performed a rare and highly complex surgery in which a 26-year-old woman underwent a Caesarean section followed immediately by double heart valve replacement. According to the institute, this is the first such procedure in Uttar Pradesh and the fourth reported case in India.
The woman, pregnant with her first child, was referred to SGPGIMS at 32 weeks of gestation with severe breathlessness and palpitations. Detailed evaluation revealed critical disease of both the aortic and mitral heart valves. Doctors determined that continuing the pregnancy or attempting a vaginal delivery would pose a serious risk to both the mother and the baby.
A multidisciplinary team comprising specialists from Maternal and Reproductive Health, Cardiology, Cardiovascular and Thoracic Surgery (CVTS), Cardiac Anaesthesiology, and Neonatology developed a carefully coordinated treatment plan.
On July 21, the team first performed a Caesarean section, delivering a healthy baby girl weighing 2.1 kg. Immediately afterwards, the patient underwent open-heart surgery, during which both diseased heart valves were successfully replaced.
Prof. Neeta Singh, Department of Maternal and Reproductive Health, said the procedure required meticulous planning and coordination. After the baby was delivered, the uterus was closed and the abdomen was temporarily packed. The patient was then placed on cardiopulmonary bypass for double valve replacement. Because blood-thinning medication required during bypass significantly increases the risk of bleeding, the surgical team maintained uterine tone with medications and continuous uterine massage throughout the cardiac procedure. After completion of the heart surgery, the abdomen was reopened, carefully inspected for bleeding, haemostasis was secured, and the abdomen was safely closed.
The patient's recovery was smooth. She was weaned off the ventilator within a few hours after surgery and did not require any blood transfusion during her stay in the intensive care unit.
Congratulating the team, Padma Shri Prof. R.K. Dhiman, Director, SGPGIMS, said the successful outcome reflects the institute's strength in multidisciplinary teamwork and its ability to manage some of the most challenging high-risk cases.
Multidisciplinary Surgical Team
Maternal and Reproductive Health (MRH): pro. Neeta Singh, Dr. Monali V. Khergade, pro and head Mandakini Pradhan; Senior Residents: Dr. Aparajita, Dr. Pragya and Dr. Sahithi.
Cardiovascular and Thoracic Surgery (CVTS): Dr. M. Munshi, pro. Shantanu Pandey, pro. S.K. Agrawal; Senior Residents: Dr. Saurabh Tripathi and Dr. Vivek.
Cardiac Anaesthesiology: Dr. Amit Rastogi, Dr. Larab Sheikh; Senior Residents: Dr. Shraddha Gangele, Dr. Sarbani Ghosh and Dr. Shivendra Pratap Singh.
Cardiology: pro. Satyendra Tiwari, pro. Rupali Khanna; Senior Resident: Dr. Harshit Khare.
The Neonatology team, nursing staff, perfusionists and other support staff also played an essential role in the successful management of this rare and complex case.
