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“For the first time, a highly complex successful treatment combining the advanced techniques of Coronary Angioplasty with non-surgical insertion of ventricularassist IMPELLA pump, Rotablation technology and the advanced Coronary Lithotripsy treatment that spanned over 11 hours was performed in Hybrid Cath Lab”

July 6th, 2020: Kauvery Hospital, a leading tertiary care and multi-specialty hospital in Chennai successfully breathed life into an 81 years octogenarian, who had very critical heap of heavy cemented 99% block in the left main artery of his heart. With very little blood flowing into the heart, the patient was at a high risk of sudden cardiac death any moment like a ticking time bomb and required urgent medical intervention, of course carrying a high risk.

Diagnosed with an impending heart attack, which later progressed to heart attack during the course of medical treatment, the patient’s condition was further complicated with acute fast progressing heart failure, fluid congestion in lungs lowering his oxygen levels and also having severe leakage of the heart valve due to critically reduced blood flow to the heart. After performing a high risk Coronary Angiography (a diagnostic procedure to study the blood flow through arteries in a heart), it was noted that the patient had a heavy, intensely calcified hardened block in the left main artery and its major branches. His heart was sustained on very trivial (<10%) flow of blood that conferred high risk of sudden cardiac arrest any moment.

Along with this critical heart condition, the patient who is a cancer survivor also had other co-existing medical ailments such as permanent cardiac pacemaker, on blood thinners for stroke prevention, Diabetes, Sleep Apnoea, Chronic Lung disease, compromised kidney function, Hypertension, High Cholesterol and Obesity. He also has multiple blocked arteries elsewhere – complete calcified blocks to arteries of both arms and critical blocks in all the three arteries of the Gastro-intestinal tract. These conditions added significant risk to any form of treatment with lower success rate- the chances of survival from the treatment were meagre.

Speaking about the most complex medical treatment procedure that was successfully performed, Dr. Manoj S, Senior Consultant and Interventional Cardiologist, said, “Initially it was agreed to perform a bypass grafting surgery that allows us to create a new passage for blood to flow around the blocked artery. But after evaluating his health assessment, we found that he showed a bleak outcome of recovery. Therefore, the option of Bypass surgery was dropped. The only other option that was left was, to perform a very high risk complex angioplasty to open the blocked main artery and restore the blood flow. However this angioplasty treatment required a heart pump – an internally placed device named IMPELLA pump – to protect and support his failing heart.

To perform the highly complex angioplasty, we had to create an access in the artery of his right arm that was completely blocked with dense calcium. However, opening of this artery to right arm carried significant risk of stroke as this artery was very close to the artery that supplies blood to the brain. His brain was sustained only on two of the 4 arteries for its blood flow. These complexities necessitated his treatment to be done in two stages to reduce the risks from the procedure and to his life.

The first stage of peripheral angioplasty successfully created the access in the artery of his right arm by using high shockwaves energy to break down the hard cemented blocks guided by an advanced Ultrasound imaging technique. During this procedure, temporary filters were placed in arteries on either side of his brain to help prevent a stroke. This is the first time ever in South India, the novel and most advanced Shock wave balloon Lithotripsy treatment to blocks in peripheral arteries with ultrasound image guidance has been performed”

After 24 hours of the first procedure, the patient was wheeled into the Hybrid Cath Lab for his second procedure. The Hybrid Cath lab provides the most suitable arena to allow complex heart treatments as well as simultaneous heart surgeries in same operating room increasing the probability of treatment success. The Hybrid Cath lab is completely and thoroughly equipped with advanced infrastructure to handle any life threatening complications.

Continuing to speak about the second phase of treatment, Dr. Manoj S said, “We began the complex high risk treatment, by insertion of the IMPELLA ventricular assist pump device to help maintain the circulation of blood as well as reduce the work load of his failing heart. We had also placed him additionally on an ECMO (an external machine to support with circulation of blood through an artificial lung) as we anticipated a high risk of Cardiac Arrest. With support from the IMPELLA heart pump and ECMO, we were certain that the patient was completely protected from any life threatening complications. We were then able to successfully remove the hard critical blocks in the main artery of his heart through a life saving Angioplasty that went on for over 11 hours duration. It is for the first time in medical history that such an effective combination of advanced heart therapies with use of Impella Heart Pump, ECMO, Rotablation and the novel Shock Wave Lithotripsy treatment has been used in saving a life.”

Dr. Manoj S was comprehensively assisted by Dr. Sundar Chidambaram – Senior Cardiologist, Dr. Raghuram – Chief Cardio Thoracic surgeon with his able Cardiac Critical care specialist and perfusionist.

Speaking on this achievement, Dr. Aravindan Selvaraj, Executive Director, Kauvery Hospital, said, “The innovation and expertise put forth by the doctors at Kauvery Hospital never ceases to amaze me. I congratulate Dr. Manoj. S for successfully pulling off a very high-risk surgery and saving the life of the 81 year old gentleman. With many odds against a positive favour, Dr.Manoj and his team came up with a brilliant surgical plan and executed it to perfection to bring out the best outcome. We are extremely happy to have supported him with infrastructure like advanced Hybrid Cath Lab that helps in facilitating these kind of challenging surgeries”

About Kauvery Hospital:

Kauvery Hospitals is ‘A new Age Family Hospital’ with Multi Specialty Clinical Expertise and a pioneer in the ‘HealthCare Provider’ industry, making healthcare affordable. Kauvery is one of the few corporate hospital chains to successfully integrate operations into Tier 1 cities after launching into Tier 2 cities. It is also one of the few hospitals founded by Medical experts and managed by business professionals with a keen focus on delivering personalized and specialized health care with warmth.

Kauvery Hospitals is currently a 1200 bed hospital group with presence in Chennai, Trichy, Hosur, Salem&Karaikudi in addition to planned entry in new markets.

Apart from having diverse Multispecialty tertiary care expertise, Kauvery Hospitals house one of three ‘Cardiac Centers of Excellence in South India’ and the only one in Tiruchirappalli (Trichy).

In today’s times where the healthcare industry is more and more commoditized, Kauvery Hospitals stands tall with its promise of making medical expertise and technology truly affordable with empathy and care at every stage of a person’s healthcare needs.