Doctors successfully removed a metallic stent from a 35-year-old's heart, that migrated there from his liver, in a challenging surgery.

A patient developed a large hole inside his aorta, the main artery, as a result of a metal stent that was placed inside a vein in the liver, to treat him for a condition called 'Budd chiari' syndrome two years ago. The metal stent slowly migrated from the liver through the vein into the right side of the heart (called a right atrium) and then subsequently ruptured the aorta.

He was presented to doctors at Fortis Escorts Heart Institute with severe symptoms of heart failure, deranged liver function, and low platelet count. The right side of his heart became almost like a large football due to the failure of the right side valve and an excessive blood flow to the right heart in a condition called a shunt, where blood flows abnormally inside the heart from one chamber to the other.

A team of 12 doctors and paramedics removed the metallic stent that was totally buried inside his vein in the heart in a surgery that lasted almost 9 hours. The doctors stopped his heart using a very advanced technique and then cut the metallic stent, even as his aortic rupture was closed and his right-sided heart valve was repaired, said Dr Ritwick Raj Bhuyan, Director, Cardiothoracic Vascular Surgery, Fortis Escorts Heart Institute, in a statement.

"It is extremely rare for an IVC stent to cause a ruptured aortic sinus. According to published medical literature, such an incident has not previously occurred," Bhuyan said. In general, surgery of this nature has only a 30 per cent chance of survival, as there was a very high risk of heart rupture, uncontrolled bleeding, and liver failure after surgery.

But, he was discharged within 2 weeks of the operation and also resumed his normal activities. As he had deranged liver and heart function, he will need cardiac rehabilitation for at least three months and must abstain from alcohol, smoking, and drink only moderate amounts of fluid, Bhuyan said.