Rare cardiac surgery performed on teen at HMC

PESHAWAR: A young cardiac surgeon, Dr Muhammad Aasim Khan, has performed rare cardiac surgery on a 20-year-old patient, the only child of his parents.

“This successful surgery will change the evidence in available medical literature, demonstrating that pulmonary arteries can grow successfully with an appropriately placed shunt in teenagers and adult adults,” Dr Muhammad Aasim, head of cardiac surgery department of the Hayatabad Medical Complex (HMC), told The News.

This unique cardiac surgery was conducted at the Hayatabad Medical Complex (HMC) in Peshawar.

The 1st part of this surgery, which is called Aasim’s shunt, his own innovation, was done in 2021, and the 2nd part, a successful total correction surgery with takedown of Aasim’s shunt, was carried out last Monday.

The patient spent two days in the ICU and has fully recovered now in the ward. He is ready to be discharged from the hospital in good health on Saturday, the 5th postoperative day.

Dr Muhammad Aasim has confirmed it, saying that he has done 7 successful Aasim’s shunts for the same kind of small pulmonary arteries in complex congenital heart disease teenagers and young adults.

“All of them are doing well with improved symptoms, some becoming eligible for the 2nd stage total correction operations like this gentleman. This young boy, at the age of 17 years, had a congenital cardiac disease called ToF with extreme RVOTO and hypoplasia of the pulmonary arteries,” he explained.

According to Dr Aasim, the patient was not amenable to the ideal procedure of “total cardiac correction for ToF” as he was having a very low Z-score for his pulmonary vasculature and RVOT.

“The literature so far available is western and doesn’t answer the growth of such pulmonary arteries in children older than 6 years of age. Hence, these teenagers are rendered inoperable and palliated by various medical remedies. However, to eliminate the debilitating living disability (stigmata of ToF) and cyanotic syndrome of these patients growing such pulmonary arteries to the level of total correction surgery is an ideal theoretical goal,” said the cardiac surgeon, known for his excellent skills in the country and particularly in Khyber Pakhtunkhwa and Afghanistan.

Before moving to Peshawar to serve his people, Dr Aasim was serving in a Red Crescent Society Hospital in Kabul and was well paid.

He established the cardiac surgery department in HMC, the second one in the public sector, after the Lady Reading Hospital (LRH). The cardiac surgery department in HMC has now become known for its quality of care, where it has operated more than 2250 major cardiac surgeries so far.

Dr Muhammad Aasim, logically thought of a minimally invasive (upper mini-sternotomy) shunt surgery (between ascending aorta and right pulmonary artery) using synthetic graft (PTFE 5 to 6mm), called the Aasim’s shunt after his name.

He did this shunt procedure in this 17 years old teenager in March 2021, and then the renowned paediatric cardiologist Prof Dr Ziaullah was doing an annual watch on the pulmonary arteries growth with CT-Angiogram.

In late-2023, the desired results of Dr Mohammad Aasim were achieved for the target Z-Score of the pulmonary arteries, and the patient was planned for a redo total correction surgery for a complete cure of his congenital ToF.

“On May 13, the patient now at the age of 20 years, underwent successful redo Total Correction Surgery of his major birth defects in the heart and his heart and pulmonary arteries connections have been switched to the normal human anatomy with closure of the hole (VSD) in his heart. This is the 1st successful surgery of its kind in the world, and this will change the evidence in available medical literature that pulmonary arteries can grow successfully (with appropriately placed shunt) in the teenagers and adult patients,” Dr Aasim told The News.

Dr Muhammad Aasim has operated on six more teenagers in the past three years with his Aasim’s shunt for the purpose of palliation (instantaneous improvement in disease symptoms), and he also expects the desired growth of the small pulmonary arteries for 2nd stage Total Correction surgery in those patients too.