A return from the point of no return - Press meet (02, August 2018)

What's New

Current events at MIOT

A return from the point of no return - Press meet (02, August 2018)

02nd Aug 2018

Seychelles and MIOT International go back a long way. This warm relationship is the result of the care that we have provided to the people of Seychelles, and the trust that they have in turn, placed in us and our ability to deliver on our promise.

Over the years, we have had many complex cases from the island nation. And our expertise in over 63 specialities, backed by eminent full-time doctors and some of the most sophisticated equipment in the world has enabled us to treat them with utmost care. Most of the patients have gone on to become pillars of inspiration.

We at MIOT continue to be at the service of the people of Seychelles.

We herewith present a landmark case on how MIOT performed the most complicated procedure to bring Mr. Francis Jelly Walter Labrosse (68 years old) back from the clutches of death.

Mr. Francis is the kind of energetic person who never lets age stop him from enjoying an active lifestyle. He is a loving husband, a caring father and a doting grandfather at home. Among his friends, he’s a wonderful companion. Mr. Francis also continues to work as a general manager in a construction company, where he’s much loved and respected. Yet, his cheerful and warm façade doesn’t even begin to drop a hint about the various severe complications that he has experienced in his life.

MIOT Hospitals - Press Meet Photo 2 Aug 2018
Seen in the photograph from left to right: Dr. Murali K, HOD – Endovascular Interventions, MIOT International., Mrs. Mallika Mohandas, Chairman, MIOT International., Mr. Francis, Patient from Seychelles., Dr. Vijit K. Cherian, Director – Cardiothoracic Surgery, MIOT International. (Press meet event on 02nd August 2018 at MIOT)

Previous Medical History:

Medically, Mr. Francis has had a long history of very serious conditions that have threatened his lifestyle and daily activities on a regular basis.

  1. Hypertension – He is a known case of systematic hypertension since the last 20 years and continues to be on treatment. It’s a well-known fact that having long-term high blood pressure leads to many serious heart complications.
  2. Colon Cancer – In 2013, when he learnt he had Colon Cancer, he was a shattered man. Being a life-threatening condition, he went to Pune to undergo complicated colonic resection. It turned out to be a disaster, as within five days, he underwent a re-surgery for the same, because of the complications he developed during the first surgery.
  3. Incisional Hernia – While there was relief in his family that he had defeated cancer successfully, tragedy struck again. In 2016, he was diagnosed with Incisional Hernia, which proved to be a result of his previous back-to-back surgeries. So he had to undergo surgery again.

This took his abdominal surgery count to three.

The Ordeal:

In June 2018, at about 2:30 am, Mr. Francis woke up to feel a searing pain in his abdomen. It felt like somebody was stabbing his stomach with a knife and twisting it. It was unbearable and he couldn’t even manage to stand. Alarmed by his condition, his and wife rushed him to a hospital, where it took six hours for the pain to subside completely.

Suspecting it to be more than an abdominal pain, which is related to his past medical history, his physician in Seychelles advised a CT scan to find the root cause behind it. The result revealed multiple Aneurysms in the lower region of the aorta, including the abdomen and thigh. The word ‘aneurysm’ frightened Mr. Francis. Even colon cancer or incisional hernia hadn’t scared him to this extent. It was because he had witnessed his own brother-in-law pass away due to an aneurysm. And, he knew it was life-threatening.

Sensing the urgency, his physician referred him to MIOT International, Chennai, India. Seeing the complexity of the situation, the health officials in the Seychelles government stepped in make the necessary arrangements so he can travel to MIOT as soon as possible. With their assistance, Mr. Francis packed his bags with hope and optimism, and flew to MIOT on 11th July 2018.

Diagnosis at MIOT International, Chennai, India:

750-hd-ct-scanAt MIOT, the Cardiothoracic Specialist advised Mr. Francis to undergo a CT Aortogram, suspecting more complexity in his case. The hospital’s state-of-the-art 750 HD CT scanner revealed a more clear and accurate diagnosis. The Imaging Sciences Department found a large aneurysm in the Descending Aorta of the Heart, the primary reason behind his painful ordeal.

It left the MIOT’s Doctors team (Cardiothoracic and Endovascular) with only two options to treat his condition –

  • Open Heart Surgery
  • Endovascular Stent Repair Procedure (EVSR)
Disadvantages with open heart surgery in this case
  • The large aneurysm seen in the Descending Aorta of the Heart was critically located in the region of the upper chest. So surgical access to it would be very complex and challenging
  • It was also in close proximity to the spinal vessels, which supply blood to the spine. One wrong move and the patient might turn a paraplegic
  • Open surgery in this location carries higher risks of multiple blood transfusions, kidney dysfunction, stroke, lung infections, paraplegia and abdominal complications and would require a heart lung machine during surgery
  • Surgery would mean that there is risk of heavy bleeding and infection leading to a prolonged hospital stay
Hence Open Heart Surgery was ruled out, considering the above complexity for this case and also the patient had already undergone three surgeries in the abdominal region.

Why Endovascular Stent Repair Procedure (EVSR):

  • EVSR is a minimally invasive procedure, which gives greater advantage while accessing the aneurysm region compared to open heart surgery, and also eliminates the risk of bleeding complications
  • As a result, the outcome of the treatment will be better, risk of post-operative infection is lesser, patients are back on their feet much earlier and the recovery is faster
Though EVSR is a more complex procedure than open heart surgery, MIOT is one of the very few centers, which is adept at handling such rare cases, thanks to an experienced and multidisciplinary team that includes cardiothoracic surgeons, endovascular specialists, anaesthetists and nurses.

Hence EVSR treatment in this case will be the only and best option for Mr. Francis ensuring his safety and quicker recovery time.

The Solution to the Ordeal:

Cathlab and Electrophysiology labThe endovascular specialist at MIOT made a small incision in the right thigh, and without any major surgery, the stent graft was taken into the aorta. The graft was deployed in the aneurysm-affected area under x-ray control in a sophisticated Cath Lab unit. As the stent graft was released, it expanded to the proper size so that it fit into the aorta both above and below the aneurysm, restoring the blood flow back inside the aorta.

Since the blood flow is channelized back inside the normal aortic passage, the primary Descending Thoracic Aortic Aneurysm site is cut off from the blood supply thereby shrinking in due course to normalcy including the other secondary aneurysms seen in the abdomen.

Illustrator diagram of procedure

MIOT International Press Release Diagram

Result:

Once the procedure was completed, Mr. Francis was monitored 24×7 in the ICU. His blood pressure was monitored and kept under control.

He recovered after two days and showed not a single sign of pain or discomfort. A CT taken recently revealed that the aneurysm had completed withered away.

Now, he is just eager to go back to Seychelles and be with his folks to celebrate his birthday.

We at MIOT International thank the government and the people of Seychelles for their continued trust and belief in the care that we provide. And we are committed to serving them with grace.

About MIOT INSTITUTE OF CARDIAC CARE

From treating life threatening heart attacks to taking care of days old blue babies, MIOT Institute of Cardiac Care has both the infrastructure and expertise to offer patients care for the entire spectrum of diseases and disorders.

  • The MIOT Centre for Thoracic and Cardiovascular Surgery unit performs more than 1000 surgeries annually which includes Coronary Artery Disease, Valvular Heart disease, Diseases of Aorta, Heart failure treatment, General Thoracic surgeries, Vascular surgeries and Adult Congenital heart diseases with a success rate matching global standards.
  • The MIOT Endovascular team performs complex stent-grafting for repair of aortic aneurysms in the chest and abdomen, Neuro-endovascular stenting for acute ischemic strokes, Embolisation of brain aneurysm / AVM / fistulae, Angioplasty and stenting for stroke prevention and Peripheral Vascular Interventions.
Glossary:
  • AORTA is the largest blood vessel in the human body that supplies oxygenated blood from the heart to the circulatory system
  • AORTIC ANEURYSM: Although the aorta is a tough, durable workhorse, its walls can weaken sometimes. The blood that flows inside the aorta finds ways through these weak walls in the aorta and creates intense pressure, causing the walls to bulge; this is called an aortic aneurysm. Aneurysm is lethal because it can rupture any moment and cause internal bleeding, eventually leading to death
  • COLON CANCERis cancer of the large intestine (colon), which is the final part of the digestive tract
  • DESCENDING THORACIC AORTIC ANEURYSMis a bulge in the descending thoracic aorta, which is located in the back of the chest cavity
  • ENDOVASCULAR STENT REPAIR PROCEDURE (EVSR) is a minimally invasive procedure in the aorta for repairing aortic aneurysms
  • INCISIONAL HERNIAis a type of hernia caused by an incompletely-healed surgical wound