Ross Procedure<\/a>, a complex double-valve operation in which my diseased aortic valve was replaced with my own pulmonary valve, and a cadaveric pulmonary homograft was implanted in its place. The architecture of the surgery was elegant in theory \u2014 biologic, durable, restorative.<\/p>\nBut within twenty-four hours post-operatively, the pulmonary valve failed to coapt. The leaflets would not seal properly, and acute right heart failure followed. What began as recovery became a crisis.<\/p>\n
<\/p>\n
Post-Op Crisis: Cardiogenic Shock, ECMO and Fasciotomy<\/h2>\n
As my right ventricle struggled, a rare coronary vasospasm compounded the instability, pushing me into cardiogenic shock. My heart could no longer maintain effective circulation. I was placed on ECMO \u2014 extracorporeal membrane oxygenation \u2014 life support that oxygenates and circulates blood outside the body so the heart can rest. In the operating room and cardiac ICU, teams worked urgently to stabilize me. The failed homograft was replaced with a pulmonary porcine valve \u2014 a second attempt at restoring forward flow. But, by then, my body had entered a fragile and unforgiving state.<\/p>\n
The prolonged shock compromised perfusion to my extremities, leading to acute right compartment syndrome. Pressure built rapidly within the muscle compartments of my leg, threatening irreversible tissue damage. An emergency fasciotomy was performed to relieve that pressure. In the arithmetic of critical care, the decision narrowed to life over limb. Though my life was saved, ischemic injury ultimately resulted in the partial amputation of my right foot.<\/p>\n
<\/p>\n
![\"Padma](\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/..\/Images\/Padma-Iyer-Foot-Before-Amputation.jpg\")
Padma’s Foot Before Partial Amputation<\/p>\n
<\/p>\n
For those in the heart valve surgery community, terms like graft failure, right heart failure, cardiogenic shock, ECMO, and fasciotomy are clinically precise. But beneath that precision lies a human disorientation that is harder to name. I spent ninety-two days in the hospital \u2014 cardiac ICU, long-term acute care, and inpatient rehabilitation \u2014 relearning how to speak after prolonged intubation, rebuilding muscle in physical therapy, and retraining my heart in cardiac rehabilitation. Recovery was not dramatic. It was incremental \u2014 the first unsteady step, the first clear sentence, the first day without overwhelming fatigue.<\/p>\n
<\/p>\n
Family Support & Buddhist Philosophy<\/h2>\n
My family endured this arc alongside me. My eight-year-old daughter sensed the gravity in whispered conversations and saw her mother through FaceTime screens framed by tubes and machines. At home, normalcy became a sacred ritual \u2014 hurried school mornings, lunch sandwiches, hospital calls layered over breakfast. When a heart falters, an entire family recalibrates its rhythm. Valve surgery does not simply alter hemodynamics; it reshapes identity, childhood, marriage, and motherhood.<\/p>\n
<\/p>\n
![\"Patient](\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/..\/Images\/padma-family-support.jpg\")
<\/p>\n
Padma, Chitra (Mother-in-law), Geeta, (Mother), Naganath (Dad), Gopiraj (Husband) and Samyuktha (Daughter)<\/p>\n
<\/p>\n
Recovery eventually carried me far from the fluorescent glare of the cardiac ICU and the mechanical rhythm of monitors. Long after the alarms quieted, something within me remained unsettled. Survival had repaired my circulation, but it had fractured my certainty. I found myself searching \u2014 not for another procedure or prognosis \u2014 but for language that could hold what medicine could not explain.<\/p>\n
That search led me to Buddhist philosophy.<\/p>\n
I encountered a different vocabulary for survival: anicca \u2014 impermanence; dukkha \u2014 the inevitability of suffering; karma; and Runanubandha \u2014 the unseen bonds that tether souls across time. These were not abstract spiritual ideas. They felt diagnostic. Impermanence explained the collapse of the life I thought was stable. Suffering was no longer an aberration to be corrected, but a condition to be understood. Karma was not punishment, but continuity \u2014 the unfolding of causes and consequences beyond my narrow sense of control.<\/p>\n
Who was I without physical certainty? Without the illusion of control? Without the identity I had constructed around capability and output?<\/p>\n
Spiritual reckoning did not heal my sternum or restore my missing toes. It offered something subtler: equanimity. A reframing of resilience not as domination over circumstance, but as integration with it. Not conquest, but acceptance. Not speed, but awareness.<\/p>\n
Before surgery, my life pulsed through the global banking and technology corridors of Bangalore, the UK, and Los Angeles \u2014 ambition, startups, late-night product debates, the velocity of building systems designed to scale globally. I led high-performing teams and thrived on complexity. I believed stamina was synonymous with strength. The heart, to me, was metaphorical \u2014 drive, grit, velocity. It took surgical failure \u2014 graft failure, cardiogenic shock, ECMO \u2014 to remind me that the heart is also muscle, tissue, and vulnerable.<\/p>\n
Buddhist philosophy speaks of non-attachment \u2014 not indifference, but freedom from clinging. I began to see how tightly I had clung to identity: executive, strategist, builder. When the body faltered, those attachments trembled.<\/p>\n
<\/p>\n
How Is Padma Today?<\/h2>\n
Fast forward to the present day. In global technology, leadership no longer means performative endurance. It is about truth-telling. It means acknowledging fragility without surrendering competence. It means modeling steadiness rather than invincibility. Motherhood, too, was redefined \u2014 hurried school mornings, gratitude woven into routine, hospital memories softened into rituals of presence.<\/p>\n
<\/p>\n
![\"Padma](\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/..\/Images\/padma-walking-after-heart-surgery.jpg\")
<\/p>\n
<\/p>\n
My lived experience has taught me that compassion begins with seeing clearly. I learned to extend that compassion inward \u2014 to the scar across my sternum, to the prosthetic adjustments, to the slower gait that once would have frustrated me. Strength became quieter. More deliberate. Less attached to speed.<\/p>\n
<\/p>\n
![\"Heart](\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/..\/Images\/heart-algorithm-padma-iyer.jpg\")
Padma’s New Book: The Heart Algorithm<\/p>\n
<\/p>\n
From these lived experiences \u2014 cardiac ICU, tech ambition, contemplation, spiritual restoration \u2014 emerged my debut novel, The Heart Algorithm<\/a> \u2013 A Story of Runanubandha. It is a work of literary fiction at the edge of narrative medicine, tracing not only surgical complication \u2014 graft failure, cardiogenic shock, ECMO, fasciotomy \u2014 but the deeper architecture of rebuilding identity after trauma.<\/p>\nThis blog post within the heart valve surgery community is an invitation: to speak not only about gradients and graft durability, but about impermanence, attachment, meaning, and agency. Today, my heart beats with a porcine valve and a scarred sternum. It beats with memory. And it beats, above all, with intention \u2014 steady, aware, and fully present.<\/p>\n
Best,
\nPadma<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":43494,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[40],"tags":[],"class_list":["post-43332","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-patient-stories"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts\/43332","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/comments?post=43332"}],"version-history":[{"count":3,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts\/43332\/revisions"}],"predecessor-version":[{"id":43502,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/posts\/43332\/revisions\/43502"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/media\/43494"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/media?parent=43332"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/categories?post=43332"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/wp-json\/wp\/v2\/tags?post=43332"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
![\"Padma](\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/..\/Images\/padma-iyer-ross-heart-surgery-patient.jpg\")
Padma Iyer (Heart Valve Surgery Patient)<\/p>\n