Bengaluru: Fifty-eight-year-old Sam (name changed) from Nigeria was having severe difficulty while breathing for the past three months and was not able to even walk a few steps. After failing to get proper medical treatment in his home country, he approached a city hospital.
“We diagnosed him with chronic pulmonary embolism, which causes formation of blood clots in the leg veins. This later enters the main blood vessel (pulmonary artery) and cuts off blood supply to parts or whole of the lungs,” says Dr Umesh Nareppa, Consultant Cardiothoracic Surgeon, BGS Global Hospital, Kengeri. The only way to remove the clots was pulmonary endarterectomy or surgical removal of blood clots from the lungs, he added.
The doctors performed the surgery under deep hypothermic circulatory arrest as excessive bleeding would have made it difficult for them to operate. This procedure helps surgeons work in a bloodless field and easily remove the clots from the blood vessels.
“Under this procedure, the patient is connected to a heart-lung machine, which does the work of the heart and lungs and cools the patient. The patient is cooled slowly to a temperature of 18 degrees Celsius and once this temperature is achieved, the circulation is completely stopped, the heart is arrested and the blood is drained completely from the body,” Dr Umesh explained.
However, there is a safe period of only 20 minutes, after which irreversible damage happens to the brain and other organs. Hence the clots have to be removed and the circulation should be restarted within that stipulated period. This condition is avoided mostly by surgeons because of this very risk associated with the surgery wherein the person is in induced coma and there is no life in the body.
“The entire procedure took us five hours, but the clots had to be removed in twenty minutes,” added Dr Umesh.
As for issues related to discontinuous breathing Dr Umesh said, “Some people have an increased tendency to develop clots. People who are bed-ridden (after surgery or due to any illness), obese individuals, women taking oral contraceptive pills, run that risk and the condition can become life-threatening." After a successfully surgery, Sam is under observation at the hospital ICU and would be soon shifted to the ward.
