Rare large fungal ball from heart valve of elderly man removed by doctors

New Delhi, Aug 10: A 70-year-old man diagnosed with a rare condition got a fresh lease of life after undergoing a complex surgery in which doctors extracted a "6 cm-long fungal ball" from his heart valve, hospital authorities said on Tuesday.

Interacting with reporters here, the patient Suresh Chandra said he had contracted COVID-19 in May 2021 and had recovered at home.

But a few months later, Chandra said he started having persistent cough and high fever, news agency PTI reported.

"I consulted various doctors. Everyone assumed it to be a post-Covid complication, and presumed it to be due to lung infection," he said, adding he has a history of aortic valve replacement.

Chandra then approached doctors at Fortis hospital where they diagnosed it as "rare fungal infection termed infective endocarditis", authorities said.

A team of doctors led by Dr Udgeath Dhir, director and head of cardiothoracic and vascular surgery (CTVS), Fortis Memorial Research Institute, Gurgaon, managed the case and through a complex surgery, successfully extracted the 6 cm-long fungal ball from the patient's heart valve, a hospital statement said.

"This is a very rare case, sometimes found in cardiac surgery patients worldwide and chances of survival are only 50 per cent," it said.

The surgery took place a few months ago. Post-surgery "anti-fungal IV continued for another 45 days" under their supervision. The patient stabilised and recovered completely and he is doing well now, they said.

"Prior to the surgery, the patient's heart function had dropped to 25 per cent and he was in shock failure (infection in the body had compromised heart function and led to difficulty in breathing).

"The doctors performed a high-risk redo aortic valve replacement surgery to detoxify his body using special filters and by placing the patient on artificial heart lung machine to remove as much infection as possible," it said.

Dr Dhir said, "Fungal endocarditis is a very uncommon case, which happens in the aortic valve of the heart. In this patient, the fungal ball covered around 7 cm of the heart's aortic valve which is also a rare condition.

"In such cases, 50 per cent of people die and the success rate is low as with every heartbeat, the heavy fungal ball was popping out, which could have resulted in a major paralytic attack, a kidney or a limb problem".

The aorta transports blood to all the body parts and with every beat, some component of the fungus was going into the blood and, therefore, to all the body parts, he said.

"Platelets were also very less in number i.e. below 1,00,000 and it was tough to operate on him. As the patient had already undergone surgery of the aortic valve, we did a redo surgery with fungal endocarditis.

"We changed his valve and after three months, evaluated him through echocardiography, which showed that the valve is functioning fine, and there is no level of infection, as of now, in the body," he said.