32-Year-Old Man With Chronic Thromboembolic Pulmonary Hypertension Gets A Second Lease Of Life
- Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is a rare progressive disease which causes heart failure and results in death
- Most of the patients go undiagnosed and have a high mortality rate is left untreated
- A multidisciplinary treatment approach which involves surgery and medication is the need of the hour
Mumbai: A team led by Dr. Bipeenchandra Bhamre, Cardio-Thoracic Surgeon, Sir H N Reliance Foundation Hospital and Research Centre, Mumbai, successfully performed a pulmonary thromboembolectomy on a 32-year-old man from Shahada, Nandurbar, suffering from Chronic thromboembolic pulmonary hypertension (CTEPH) which is caused by blood clots, and leads to breathlessness, fatigue, and swelling of legs.
Two years ago, Siraj Ansari, a businessman from Nandurbar was jolted out of his normal life after he encountered severe breathlessness. This made it difficult for him to do his daily activities, and concentrate on his business. He consulted few medicos who confirmed that he suffered from Thromboembolic Pulmonary Hypertension (CTEPH) which can ultimately lead to heart failure.
CTEPH is a rare and progressive form of pulmonary hypertension (PH) wherein the repeated blood clots in one’s lung get stuck, and tend to clog arteries which may turn into scar tissue, as time passes. Furthermore, the blood vessels become narrow and clogged, and pulmonary pressure increases, and causes PH. This means one’s right side of the heart has to pump harder to get blood pass through and leads to a back-up of blood returning from the veins to the heart. Thus, the right side of the heart works harder to keep up with the blood flow, and this may weaken the heart, result in swelling and heart failure.
Fortunately, he recovered from that episode and was on anticoagulation medications to dissolve the clot in the lungs. But, Siraj’s life took a turn for worse in 2019, when he couldn’t breathe or walk and would cough up blood continuously. His family was alarmed and started looking out for treatment options. However, the patient was referred to Dr Bipeenchandra Bhamre, who saved his life.
Dr Bipeenchandra Bhamre, Cardio-Thoracic Surgeon, Sir H N Reliance Foundation Hospital and Research Centre, Mumbai, highlighted, “15 days ago, the patient was admitted at H.N. Reliance foundation hospital due to breathlessness. A ventilation-perfusion scan (V/Q) was done which is vital for the diagnosis of CTEPH along with echocardiography which indicated raised pulmonary artery pressures and right ventricle dysfunction.”
He added, “Sometimes, surgery is considered as risky in patients whose pulmonary artery pressure is as high as this patient, and they aren't evaluated further or given surgical management, particularly when right heart failure has developed. In fact, there is no limit beyond which surgery is contraindicated in terms of pulmonary hypertension. In fact, patients with the most severe elevated pulmonary artery pressure derive the greatest benefit from surgery.”
Siraj underwent pulmonary thromboembolectomy on August 14. “This curative surgery removes blood clots and scar tissue from pulmonary arteries. The patient is cooled to 18 degree Celsius and a circulatory arrest technique on the cardiopulmonary bypass machine is used. The surgery lasted for how many 8 hours, and the patient was discharged after a week,” underscored Dr Bhamre.
Patient Mr Siraj stated, “My life was miserable as I wasn’t able to breathe or swallow food 15 days. Owing to severe breathlessness, and inability to walk, it was impossible for me to look before my business. My health kept on deteriorating, however, a timely intervention by Dr Bhamre saved my life. After surgery, I can breathe easily and move freely. I am happy that I have resumed my daily routine.”
