How docs revived patient’s failing heart during brain surgery

“This was one of the most intense moments in my surgical journey of over 44 years,” recalls Dr. P. Ranganadham, HOD & Senior Consultant – Neuro Surgery at Aster Prime Hospitals.

Imagine a patient lying on the operating table with his skull open, the protective covering of his brain cut away, and his heart suddenly stopped functioning, he said.

Displaying medical expertise and nerve, a team of doctors revived a 43-year-old carpenter who suffered a cardiac arrest midway through a high-risk brain surgery, and then proceeded to finish the operation.

The critical procedure

The patient, a diabetic weighing 82 kgs, had been admitted for the removal of a tumor on the right side of his brain. Under the leadership of Dr. Ranganadham and a team including senior anesthetists Dr. Praveen Chandra and Dr. Lanka Krishna, the surgery began as planned.

However, approximately 60 minutes into the procedure, the situation took a terrifying turn.

“After partial tumor removal and the opening of the brain, the patient’s heart rate suddenly plummeted, leading to cardiac arrest,” Dr. Ranganadham recounted.

The surgical team faced an immediate and complex challenge. In neurosurgery, the patient’s head is typically elevated to manage intracranial pressure, a position that makes standard CPR nearly impossible.

“Performing CPR during open brain surgery presents exceptional challenges,” said Dr. Ranganadham. “The team swiftly flattened the operating table to enable effective resuscitation and administered three rounds of electrical stimulation of the heart with a defibrillator,” added the team.

A battle against time

“For nearly an hour, the team worked relentlessly, and after sustained efforts, the patient’s heart restarted. Despite the crisis, the surgery continued. With the very strong skull bone flap outside, the protective brain covering duramater (aka dura) kept aside, the brain began swelling outward, which was a tense moment. But, visible pulsations of the brain confirmed restored circulation to it. The remaining tumor was successfully excised. A cardiologist who evaluated the patient intraoperatively found no major cardiac abnormality,” read the note shared by the Hospital management.

A miraculous recovery

It was further added that by the next morning, the ventilator was removed for the patient, and he woke up fully conscious and, defying the risks associated with right-brain surgeries, showed no signs of left-side weakness or paralysis. The patient was later discharged in a stable condition and has since returned for follow-ups in good health.