A very high-risk angioplasty of an extremely sick international patient with heart-pumping of just 15%
Mr Ousmane Komi, a 55-year-old gentleman was suffering from severe breathing difficulty and chest heaviness on minimal exertion and he was diagnosed at Mali (West Africa) with severely decreased heart pumping (LVEF 15%) (normal pumping is 60%) and very high lung pressures by an echo.
He decided to travel to Wockhardt Hospitals, South Mumbai – India for further treatment under Dr Ravi Gupta (Interventional Cardiologist) Unfortunately, he developed covid in transit and was found covid positive on admission. But he was well managed in COVID-ICU. On cardiac investigation, it was revealed that he had 100% very old and hard blockages in two out of three of his heart arteries. He was very breathless even at rest and used to develop the fluid collection in his lungs repeatedly due to severe heart failure. The fluid was tapped multiple times.
In this situation, the opening of these arteries was very important and crucial as the heart pumping would improve only after the restoration of blood supply to the heart. He was totally unfit for bypass surgery. Viability assessment showed that right coronary artery angioplasty would be life-saving in his case. His blood pressure was very low and the angioplasty started at 80/60 blood pressure. Initially, the Impella device was planned for blood pressure support but, a clot in the heart did not allow the cardiologist to use that. Another heart support IABP (Intra aortic balloon pump) was used and angioplasty of a very difficult CTO (Chronic Total Occlusion) was performed by Dr Ravi Gupta and his team successfully.
The patient responded dramatically, and his heart pumping improved to 30%. His general condition and all the symptoms of severe heart failure have also vanished. He has been discharged in a healthy state.
Dr Ravi Gupta, a consultant interventional cardiologist from the Wockhardt Hospitals, South Mumbai – India, said that he has seen many such patients who come with 100% very old blockages in the heart, known as Chronic Total Occlusion cases (CTO) and they have shown great results with angioplasties. These treatments have proved to be life-saving and such cardiac patients have improved significantly. Another patient from Burkina Faso was also treated in the same month for similar blockages.
“We had to perform two angioplasty procedures for this patient, which were extremely risky, as his heart pumping rate, as well as the blood pressure, was very low. However, after treatment, his heart rate improved to 30%,” said Dr Gupta.
It has been an unprecedented challenging period for international medical travellers during the last 18 months owing to COVID-19 restrictions. ‘Our inbound patients have been facing a lot of hindrances in the form of flight restrictions, stringent visa rules, closed borders, local lockdowns and fear psychosis of travelling during this period for elective surgeries. Despite all this, quite a few patients from the Middle East and Africa have travelled and successfully treated at our Wockhardt hospital facilities as quoted by Mr Somnath Shetty, who heads the group for international patients for Wockhardt Hospitals.
Ousmane Komi, 54-year-old, a resident of Mali (West Africa), with 15% heart-pumping capacity, landed in Mumbai on May 27, 2021. “Due to uncertainty about flights, it took me three days to reach Mumbai. However, I am very happy to meet the doctor and the Wockhardt staff who took my utmost care. I had breathlessness and limb swelling and the chest showed bilateral significant pleural effusion (water on lungs). But now I am breathing well and feeling good,” he said.