Congolese woman undergoes bloodless open-heart surgery in Bengaluru

BENGALURU: A 39-year-old woman from Democratic Republic of Congo, suffering from cardiac ailments, underwent a bloodless open-heart surgery and valve repair in Bengaluru.
Bibiche Tshibola Makolo suffered from restrictive cardiomyopathy, which hinders the heart’s stretching and results in bleeding. She required an open-heart surgery to fix the heart valves and contain the bleeding.

Bibiche belongs to Jehovah’s Witness community which prohibits receiving blood or blood products. While over 6-8 units of blood are commonly used in an open-heart surgery, it was ruled out in Bibiche’s case.

“When she was brought to the hospital in early February, her haemoglobin level was just 7gm per decilitre. With due respect to her religious beliefs, we recommended she undergo bloodless surgery, where a plan was made by an hematologist, an anaesthetist and a team of cardiac surgeons,” said Dr Vivek Jawali, chief cardiothoracic and vascular surgeon, chairman, department of cardiovascular sciences, Fortis Hospitals.

Operated on February 20, Bibiche is all set to fly back to Congo. She was put on a series of medications, including blood conservatives, which helped increase her haemoglobin level to 14.8gm. “The surgery was conducted using all blood conservation techniques practised at our unit for patients. It was successful and no blood transfusion was required during the entire procedure. We made sure damage to the blood components during surgery was minimal,” said Dr Jawali.

Post-surgery, her haemoglobin level was 13gm and is improving. According to Dr Murali Chakravathy, director, department of anaesthesia, the case was challenging as blood transfusion was restricted. “A bloodless surgery is risky and can lead to haemorrhagic shock in the patient. However, Bibiche responded well to treatment. We had ensured the patient and her family’s religious beliefs were duly respected and we would not conduct any blood transfusion during the surgery,” he said.

Bibiche is a homemaker and mother of three kids. She has to be on blood thinners for life to ensure she doesn’t face any cardiac issues in future. However, doctors have advised her not to conceive, considering her health condition and given that her community believes not to interfere with God’s scheme of things in life.

“We were not sure if we would receive a treatment where our beliefs are considered. We remain grateful to the doctors who operated on her and saved her with constant support,” said Roger Muamba, Bibiche’s husband.

Dr Jawali, who has conducted many bloodless surgeries, recalled that the first heart surgery he did on a patient from Jehovah’s Witness community was in 1985 when he used to work at Jayadeva hospital, Bengaluru. “Back in 1985, the technology was raw and it was much more difficult. However, if a surgeon plans on blood management prior to surgery, it can be done, despite risks. The community members, who have their main church in Canada, have displayed our contact numbers in their churches and contact us when they are in need of surgery,” said Dr Jawali.