After ten days in coma, 38-year-old man beats failed heart

Chennai: When Jaysukbhai Thaker was airlifted from Porbandar to Chennai, the 38-year-old stationery shop owner was breathless and jaundiced with a critical heart condition. A week later, his heart stopped abruptly. For nearly 45 minutes, despite the efforts of a team of doctors and paramedics at Fortis Malar Hospital, the cardiac monitor showed flat line, indicating that his heart had stopped.
Today, he was declared fit for discharge after receiving a heart harvested from a brain-dead patient couriered by Hyderabad-based hospital, which arrived by air ambulance in Chennai.Doctors say they pushed medical care to the farthest to hear a heartbeat in Thaker.
At 8.30am that day, minutes after his wife Manisha screamed for help, the floor nurse and the duty doctors dragged in the crash cart - a trolley with equipment to resuscitate a patient with heart failure - and spent 30 minutes trying to revive him. "It was tense, complex and intense situation. We knew it was do or die," said interventional cardiologist Dr Ravikumar. Thaker, who suffered from dilated cardiomyopathy, was then moved to the intensive care unit. By now, doctors knew they had lost a lot of time - blood supply to the brain and other parts of the body had dwindled.
In the intensive care unit, doctors attempted resuscitation again. This time it was an invasive procedure where the patient was connected to a portable heart-lung machine called ECMO, extracorporeal membrane oxygenator. The heart and lungs were rested and the machine took over the job of pumping blood, purifying and oxygenating his blood. "The machine routinely brings people back to life," said Dr K R Balakrishnan, cardiac sciences director, Fortis Malar. But the procedure isn't easy and is usually employed when all other avenues have been exhausted.
As the duty doctor/staff nurse massaged his heart, doctors inserted a catheter through the femoral vein, circulated the blood through an oxygenated filter, and returned it to the body.
Although blood circulation was restored, doctors were faced with the next big challenge. The patient went into a coma for nearly 10 days, possibly because the brain was blood-starved for a long period. "A blood-starved brain is one of the reasons for miserable outcomes of heart disease," said Dr Balakrishnan.
Thaker's family had all but given up. "They told me that people who go into coma never wake up. We had spent several lakhs by then. I thought I had lost my husband. But in just a few minutes I heard from the staff nurse that he had woken up," said Manisha.
When he woke up, doctors wanted to give Thaker another chance - a new heart. As a bridge to transplant, the patient was put on another machine, an artificial heart called the left ventricular assisted device (LVAD) and wait-listed the Thaker for heart transplant. Four days later the hospital received a call from the state transplant registry that heart from a brain patient in Hyderabad was available.
"We desperately needed the heart but none of us could go there to harvest it. Doctors there volunteered to harvest it but they could not travel. So, we had it couriered to us," said hospital's chief of cardiac anesthesia Dr Suresh Rao. For the first time, after nearly a fortnight doctors heard a heartbeat in Thaker.
Today, as doctors declared Thaker fit for discharge, an emotional Manisha couldn't stop crying. "Now that I can breathe easy, I will go back to my job," said Thaker.