Kauvery Hospitals performs Pulmonary Endarterectomy

Kauvery Hospitals, Alwarpet a leading healthcare institution had

performed a successful life-saving pulmonary endarterectomy

surgery on a 49-year-old patient suffering from heart failure due to

severe Chronic Thromboembolic Pulmonary Hypertension

(CTEPH).

The surgical procedure, carried out by the expert medical team

under the leadership of Dr. Kumud Dhital, Director of the

Cardiovascular & Thoracic Surgery Department & Heart-Lung

Transplantation Unit, is a notable achievement in the hospital’s

dedication to offering state-of-the-art healthcare and advanced

medical therapies. 

The patient suffered from advanced heart failure, which led to

kidney failure requiring dialysis and liver congestion. The cause of

heart failure had not been diagnosed and contrast CT could not

be done due to ongoing dialysis for acute chronic kidney failure.

He was admitted to Kauvery Hospital with breathlessness at rest,

swelling of both legs and breathing issues during the nights. 

After a thorough assessment, the Pulmonology team led by Dr

Srinivas Rajagopala considered a diagnosis of severe CTEPH

and complex Sleep Apnea - leading to heart failure.

CTEPH is a condition in which permanent blood clots form in the

major vessels leading from the heart to the lungs, causing heart

failure due to the inability to pump blood into the lungs.

Medications or stents are typically ineffective, and surgery is the

only option.  Perfusion scans confirmed this diagnosis in his case,

prompting a change in the treatment plan. 

His heart failure was aggressively managed, eventually leading to

discontinuation of dialysis, while being supported with oxygen,

home ventilator, anticoagulation, medications and home heart

support by continuous milrinone pump. Subsequently, a careful

dose-monitored contrast CT and pulmonary angiogram were done

with caution to avoid worsening of his kidneys.

This confirmed CTEPH and a complex pulmonary endarterectomy

surgery meticulously planned with inputs from Pulmonology,

cardiology and interventional radiology services. The patient

underwent the procedure under the guidance of Dr. Kumud Dhital

who has performed more than 150 successful pulmonary

endarterectomies till date.

The procedure involves placing the patient on a heart-lung

machine and cooling the patient to 20°C with carefully controlled

cardiac arrest. Careful removal of all the chronic organized clots

from deep inside the pulmonary arteries is crucial for a complete

cure & prevention of postoperative complications and this is why

meticulous pre-operative planning is important.

Post-surgery he was diligently monitored in the Heart-Lung

Intensive Care Unit (ICU), where he made remarkable progress

with normalization of pulmonary pressures and heart function,

leading to a quick discharge by the eighth day of surgery. He

remains off dialysis and has been able to stop oxygen, home

ventilator, continuous heart support and most of his medications.

He continues on anticoagulation pills alone to prevent recurrence

of blood clots. He rejoined work after 4 weeks and resumed all

activities now at 2 months post-discharge. Despite his complex

medical condition, he exhibited remarkable morale and resilience

throughout his treatment journey.

"We are delighted to share our success," said Dr. Srinivas

Rajagopala, Senior Consultant, Interventional Pulmonology &

Sleep Medicine, Director of Transplant Pulmonology & Lung

Failure Unit at Kauvery Hospital. "While we are offering

endarterectomy routinely, this patient had multiple reasons

including CTEPH at its most end-stage leading to heart failure

and our optimization of all factors and collaborative efforts led to a

favorable outcome. This is possible only in a few collegiate

environments like Kauvery Hospitals in this country” he added.

“We are delighted to see the results of the breakthrough surgical

procedure, giving hope to many who could benefit with this.  This

further motivates us to continue to provide cutting-edge therapies

and advanced techniques to ensure optimum outcomes every

time.  Kauvery Hospital continues to lead the way in

revolutionizing healthcare, ensuring a brighter, healthier future for

all.” said Dr. Aravindan Selvaraj, Co-Founder and Executive

Director, Kauvery Hospitals.