Prakash Barretto

During a routine physical for a job interview in 1990, Prakash Barretto was diagnosed with heart disease.

This discovery was a precursor to his nearly 25-year health journey that was punctuated by numerous near-death experiences, two mechanical valve replacements, an implantable cardioverter-defibrillator (ICD) and finally, in 2023, a diagnosis of recurrent ventricular tachycardia (VT). It’s a life-threatening arrhythmia that originates from the bottom chambers of the heart and was not responsive to arrhythmia medication.

“I had become so anxious about my health,” said Barretto, who works as an IT professional for Walmart in Bentonville, Arkansas. “I was afraid to leave my house or drive a car for fear that I would collapse. I had no energy. When my heart would start racing, I knew the drill – I might collapse and that could be the end.”

Barretto required cardiac ablation surgery to treat the VT. Ablation is a life-changing therapy for patients suffering from VT in which catheters can be used to burn the culprit areas to stop the abnormal rhythm. Because he had two mechanical valves, in both the mitral and aortic valve positions, standard approaches to enter the left ventricle of Barretto’s heart could not be done without causing catastrophic damage.

What Barretto required was a rare type of ablation to enter the left ventricle through a small area in the right atrium that bypasses the mechanical valves. The procedure required extensive planning along with expert skill with intracardiac ultrasound and catheters. And with approximately a dozen such procedures conducted worldwide, few surgeons were willing to commit to the task. Fortunately for Barretto, the expertise he needed was a mere three hours away in Overland Park, Kansas.

Innovative care close to home

Barretto was referred to Dr. Douglas Darden, a board-certified and fellowship-trained cardiologist specializing in cardiac electrophysiology at the Kansas City Heart Rhythm Institute at HCA Midwest Health. Darden was skilled in this novel approach and was willing to conduct the surgery.

“When we met, Dr. Darden completely understood my situation,” said Barretto. “He took the time to explain in detail how he would do my surgery. It’s been my experience that very few doctors will take the time to explain a procedure so thoroughly. He was super smart, and I felt extremely safe in his care.”

On Monday, March 18, 2024, Dr. Darden and Dr. Krishna Pothenini, cardiac electrophysiologist skilled in complex ablations, together successfully executed the rare procedure to ablate Prakash Barretto’s left ventricle at Overland Park Regional Medical Center.

“Where most patients would go untreated, we were able to successfully perform a novel approach to enter Prakash’s left ventricle through the right atrium via an area called the ‘posterosuperior process,’” said Dr. Darden. “This allowed us to bypass both mechanical valves to enter the left ventricle. Once we successfully entered the left ventricle through the right atrium, we induced the VT rhythm, mapped out the exact circuit and successfully terminated it with ablation.

“Prakash recovered remarkably well. He walked the same day and was discharged from the hospital the next day. Undoubtedly, this required a team effort at Kansas City Heart Rhythm Institute with our lab staff preparing days in advance to ensure proper equipment and the collaborative atmosphere teaming up with Dr. Pothineni to accomplish this incredibly rewarding complex procedure.”  

For Barretto, the procedure was truly life-changing.

“When Dr. Darden entered my room with a big smile on his face and told me the surgery was successful, I saw a vision of my life where I might be free of the constant worry about collapsing,” Barretto said. “I might be free to once again drive a car, return to the office and to travel back to India.”

Life renewed

Since leaving the hospital Barretto has continued to make progress. In early April he returned to the gym. And on April 9 – just 3 weeks and one day following the life-changing procedure – he drove to a local home store, purchased 14 30-pound bags of soil, drove home, unloaded the bags in his backyard and still had enough energy left to play with the family dog.

“There have been so many times when I could have died over the last 25 years,” said Barretto. “My heart has stopped so many times and somehow, the medical professionals were always able to bring me back. Some of my friends have not been so fortunate. I am a walking miracle.”