Kolkata, Jan 12:  Manipal Hospital Dhakuria, a unit of one of the largest healthcare providers of Eastern India – Manipal Hospitals Group, successfully treated Mr. Arindam Sen (name changed), a 41-year-old businessman from Kharagpur, who was diagnosed with a severe congenital heart valve disorder. He was treated under the expert care of Dr. Kaushik Mukherjee, Consultant – Cardiothoracic Surgery, Manipal Hospital Dhakuria. The case was particularly challenging due to a rare and high-risk airway condition, requiring the cardiac surgery and anaesthesia teams to work in close coordination to ensure a safe and successful outcome.

The patient was suffering from severe aortic stenosis, a life-threatening condition where the main valve that controls blood flow from the heart becomes critically narrow. This was due to a bicuspid aortic valve, a birth defect in which the valve has only two flaps instead of three, causing it to malfunction earlier in life. The patient also had a ventricular septal defect (VSD), a hole in the wall separating the lower chambers of the heart allowing blood to flow abnormally. Adding to the complexity, the patient had severe anxiety requiring long-term medication and an extremely restricted mouth opening of just one finger width, making routine anaesthesia and airway management highly dangerous. Even minor changes in heart rate or blood pressure in such cases can prove fatal.

To minimise these risks, the medical team planned an advanced and carefully controlled technique known as Awake Nasal Tracheal Intubation, where the breathing tube is gently placed through the nose while the patient remains awake and breathing on his own, avoiding sudden stress on the heart. Despite the patient’s anxiety and complex condition, the procedure was completed without any drop in oxygen levels or instability in vitals. This was followed by successful heart surgery led by Dr. Kaushik Mukherjee, in which the damaged valve was replaced and the hole in the heart was closed.

The surgery and recovery went smoothly, without any complications. He was discharged on the fourth day after surgery and is now recovering well at home, smiling and steadily regaining his strength under regular follow-up care.

Explaining the complexity of the case, Dr. Kaushik Mukherjee, Consultant – Cardiothoracic Surgery, Manipal Hospital Dhakuria said, “This patient had two serious heart conditions along with an extremely challenging airway. Severe aortic stenosis requires strict control of heart rate and blood pressure, as even minor stress can be dangerous. With detailed planning and teamwork, we were able achieve an excellent outcome. What made the case especially rewarding was the patient’s trust in our team. Despite the complexity and his anxiety, he remained calm throughout the process, and to see him recover well and walk home smiling was deeply satisfying for all of us.”

Speaking about the anaesthesia challenge, Dr. Nilanjan Chakrabarty, Consultant – Cardiac Anaesthesia, Manipal Hospital Dhakuria said, “With such limited mouth opening and severe anxiety, conventional intubation was not an option. Awake nasal intubation allowed the patient to continue breathing on his own, eliminating the risk of airway failure or cardiac instability. Managing this smoothly in a high-risk cardiac patient reflects careful technique, experience, and constant reassurance.”

Expressing his gratitude, the patient said, “After speaking to doctors at several hospitals across the country, I finally decided to get treated under Dr. Kaushik Mukherjee at Manipal Hospital Dhakuria. I was very anxious, but the team took the time to explain every step, which really put me at ease. From surgery to recovery, the care and compassion I received were truly reassuring. I am grateful to the entire team for helping me heal and return home with confidence and a smile.”

This rare and complex case highlights Manipal Hospital Dhakuria’s expertise in advanced cardiac surgery and difficult airway management, reaffirming its commitment to delivering safe and comprehensive care even in the most challenging medical situations.