86-year-old female Patient, Sumitra Sharma, a resident of Gaya (Bihar) was a known Heart disease patient. Recently, she had a slipped in the washroom at her residence and suffered a fracture of left hip (neck of femur). She had a previous history of breast cancer and had undergone angioplasty 18 years ago and was on double blood thinner medication.

She came to the emergency at Fortis Escorts Hospital, Okhla (Delhi) after three days from the date of injury, travelling all the way from Gaya (Bihar). At the time of admission, she complained of chest pain, following which an echocardiogram and other investigations were conducted which revealed an acute cardiac event along with old scarring and slow movement of part of the walls of the heart. The heart was pumping blood at 30% of the full capacity (Ejection fraction 30%). She underwent angiography before surgery and heparin was added to her blood thinners. All these co-morbidities made the patient’s condition highly complicated. The patient needed an urgent surgery. The team lead by Dr Kaushal Kant Mishra, Director – Orthopaedics and Joint Replacement, Fortis Escorts, Okhla, New Delhi performed a hip ball replacement surgery in 15 minutes 35 seconds which is the shortest duration for such surgery known so far globally. This is three minutes less than the previous world record set by Dr Mishra and his team two years ago.

Dr Kaushal Kant Mishra said “Treatment for such fracture is challenging as the patient in this case was suffering from multiple comorbidities. Timely surgery is the key in managing and saving the life as it prevents complications of prolong immobilization. The advanced age of the patient and also the fact that the patient was on dual anti-platelet drugs, heparin used for angiography two hours before the surgery posed a major risk to the surgery. Her ejection fraction was only 30% (normal is 60%).”

He further added “Spinal Anesthesia which is considered safe in lower limb surgeries was not feasible in this case, and general. anesthesia was the only choice which in itself carries many deleterious side effects considering age and diminished heart function. anesthesia challenges included generalized weakness, increased risk of postoperative memory loss and other neurological complications”

Dr. Mishra, thanks the entire medical team for this clinical achievement, as it was not possible without the collective and coordinated efforts by the team. The orthopedics team included Dr Kaushal Kant Mishra, Dr Brajesh Kaushle, Dr Ravindra Singh, Dr Sachin Sharma, Dr Mohan. Anesthsia Team included Dr Anuj under the leadership of Dr Manju and Dr Ashutosh. Cardiology team included Dr Vijay Kumar and his team.