Hi Doctor(s),

I need a favour from you. My wife hospitalized since November 2010 till February 2011 due to Acute Pancreatitis. Also doctors diagonized that she is having a severe heart problem. I am explaining the whole history of the hospitalization of the patient, just i would like to know opinion / suggestion on the patient's situation.

History of the Patient:

In  01-11-2010,  the patient was ( with symptoms: abdomen pain,back pain and vomiting) admitted in Bollineni Superspeciality Hospital, Nellore, AP. There we realized that she is suffering from severe "Acute Pancreatitis, Cholelithiasis".  Immediately shifted to Vijaya Heart Foundation hospital, Chennai. Treated 27 days with various expensive antibiotics, but no use. Infection not able to controlled. She suffered from constant fever due to infection fluid collections in the abdomen formed in the form of packets.
We demanded to discharge her on 27th day and shifted her to "Asian Institute of Gastroenterology" (AIG) hospital, Hyderabad. Medical treatment started on the admitted day itself by giving so many expensive anti-biotics. CT scan radiologist kept 2 tubes into the stomach at left side to drain the fluid collections, but right side they are not able to put the tubes as the organs are there and also fluid collections are very thick. After 3 weeks doctors planned to do major surgery as right side collections are not draining and due to this she is suffering from constant high fever. As per Cardiologist opinion, they kept the surgery on hold as she is have another issue in the heart. Heart left ventricle's ejecting factor(EF) recorded to 27% only which is severe dysfunction and high risk of giving anesthesia while surgery. After that they tried to improve the functionality, but in the span of just 2 weeks by giving medicines, it improved to 30%.
Due to this, doctors changed the opinion of surgery for the time being. CT Scan radiologist hardly tried and kept another 2 tubes into stomach through the right side of the abdomen.That way the draining is started in right side also.  Every day giving her expensive anti-biotic medicines to control the infection, doing fluid culture tests, blood tests to check Albumin, hemoglobin % and also Liver Functional Test, not to spread across the other organs. At the same time trying to improve the heart functionality, controlling the blood sugar by giving the Insulin in a daily basis. Likewise CT scan radiologist kept total 6 tubes into abdomen in both sides to drain all the infection fluid.
The root cause for all these: "formation of stones in the gall bladder, travelled through the bile duct and stuck at the Pancreas head". Doctors want to remove the gallbladder after few months of bed rest as again the existing small stones might travel. Frequent reviews and checkups after discharge (on 27-Feb-11 ) from AIG hospital. All Tubes removed from abdomen and found 'no collections' by CT review.
Planned to do open Cholecystectomy surgery at AIG on 20th May'11. But Cardiologist given the opinion as "High risk for surgery" as she is having the "Dilated Cardiomyopathy" (Severe dysfunction with 32% LV ejecting factor). Anesthesiologist  saying that on giving the anesthesia, they are not sure how the heart will respond while surgery. Went to Vijaya Heart Foundation (VHF) hospital, Chennai. VHF Cardiologist given opinion as "Fit for high risk surgery" by taking 2D ECHO. 
Doctor in AIG hospital told to come back after 30 to 45 days for Cholecystectomy surgery and should take 10 to 20% risk on the surgery inaddition to precautions. As she is diabetic, and presently she is having 347 points in random blood test, consulted Endocrinologist to control blood sugar. Now sugar is under process to control.
Present In-take Medicines (For heart issue):
Name                          Dosage  
Aldactone 25mg tab: 1 - 0 - 1
Lasix 20 mg    tablet  : 1 - 0 - 0
Carnisure 500 tablet  : 1 - 0 - 1 (Stopped now)
Coversyl 2mg tablet  : 1 - 0 - 0
Ivabradibe 5mg        : 1 - 0 - 1
For Pancreas issue:
Creon 25000  capsules: 1 - 1 - 1
Request you to provide your valuable opinion / suggestions / medications (to control Dilated Cardiomyopathy) to overcome or reduce the risk factor in a short period of time and to become fit for surgery with a minimal risk factor.
Please prescribe / suggest, if any using medicines required to change for quick improvement of heart. Because those above listed medicines (for heart) are using from middle of December 2010 to till date. But improvement is not observing much and not that much effective.
Awaiting for your reply.
Thanks a lot.
Regards,
Siva Prasad K V
BANGALORE, Karnataka, INDIA
+91-0000