Restoring Heart Function for an 83-Year-Old Patient with Severe Myocardial Infarction

Recently, doctors at the Cardiology Center of the University Medical and Pharmacy Hospital of Ho Chi Minh City (BV ĐHYD) successfully treated an 83-year-old patient with severe heart disease. The patient was admitted with severe shortness of breath, progressive acute heart failure accompanied by acute pulmonary edema due to severe bicuspid valve regurgitation after an acute myocardial infarction. In addition to heart disease, there was also a stroke issue, which made the treatment process present many challenges. However, thanks to a personalized treatment approach combining internal medicine, surgery, and intensive care anesthesia, the patient made a spectacular recovery, opening new hope for elderly patients with cardiovascular disease.

Immediately upon admission, the patient underwent a comprehensive assessment to determine the disease severity. Doppler echocardiography revealed severe bicuspid valve regurgitation due to chordae rupture, causing blood backflow, overloading the heart, leading to pulmonary congestion, pleural effusion, and acute pulmonary edema. Additionally, laboratory results also indicated signs of severe heart failure with elevated test markers, brain MRI showing areas of cerebral infarction, and coronary angiography revealing severely narrowed coronary arteries causing myocardial ischemia. These factors placed the patient in a high-risk group for surgery, requiring an optimal treatment strategy to ensure safety.

After a multidisciplinary consultation at the hospital, the doctors decided to implement an aggressive medical therapy before surgery to control heart failure, optimize kidney and respiratory function, and improve the patient's physical condition. Medical therapy helps reduce the risk of surgical complications and improves postoperative recovery.

When the patient's condition became more stable, the cardiovascular surgery team performed a replacement of both leaflets with a bioprosthetic valve and a coronary artery bypass graft. Choosing a bioprosthetic valve reduces the risk associated with anticoagulant medication, which is suitable for elderly patients. At the same time, the coronary artery bypass improves blood flow to the heart muscle, reducing the risk of future myocardial infarction recurrence.

Prof. Dr. Cao Dang Khang – Head of the Cardiovascular Surgery Department at DHYD Hospital said: “Elderly patients often have multiple comorbidities, so it is important to develop an appropriate treatment strategy, optimize the patient's condition before surgery, and choose the safest surgical strategy. The combination of preoperative medical therapy and optimized surgery and intensive care anesthesia has allowed the patient to undergo a successful operation.”

After the surgery, with thorough preparation by the cardiac anesthesia and intensive care team, the patient recovered quickly. Just two days after the operation, the patient was able to sit up, walk gently and resume normal activities. The shortness of breath completely disappeared, and heart function improved markedly. Post‑operative echocardiography showed that the mitral valve was functioning well, with no longer any regurgitation. Notably, kidney and respiratory functions were restored, with no signs of acute renal failure or respiratory failure, pneumonia – common complications in elderly patients after heart surgery.

Sharing about her father's treatment journey, Ms. L.T.T.T., the patient's daughter and also a cardiologist, could not hide her joy: “At first our family was very worried because my father is elderly and has many underlying conditions. But thanks to the dedication of the doctors and the appropriate treatment method, he recovered beyond expectations. He even wants to ride his motorbike to the hospital for a follow‑up because he feels so healthy!”

The success of this surgery further confirms the important role of personalized treatment in cardiology. Rather than applying a one‑size‑fits‑all protocol, tailoring the treatment plan to each patient's specific condition has optimized outcomes and minimized risks. This is also the direction that the Cardiovascular Center of ĐHYD Hospital consistently emphasizes to achieve the highest treatment efficacy, especially for high‑risk patients.

According to Dr. Cao Dang Khang, cardiovascular surgery is no longer an impossible feat for elderly patients as it once was. With advances in cardiovascular surgery and anesthesia intensive care, combined with modern medical treatment methods, those with complex conditions requiring heart surgery still have the chance to recover and significantly improve their quality of life.

Binh Dinh Hospital (BV ĐHYD) continues to be a reputable center for treating cardiovascular diseases, thanks to the dedication of its team of specialists and advanced treatment techniques. The success of this case not only saved a life but also opened opportunities for many other patients. Hearts that seemed to have weakened over the years can still be revived if the proper and timely treatment method is applied.