In a unique case of clinical excellence, a team of doctors at the Fortis Flt Lt. Rajan Dhall Hospital, gave a new lease of life to a 70 year old man, Yaima Singh from Manipur, by successfully treating him for 99% LAD Heart blockage (the biggest vessel of the heart) and a malignant colon tumor in 15 days. The multi-disciplinary team of doctors who treated Yaima Singh included Dr Ripen Gupta from the Cardio Sciences team, Dr Randeep Wadhawan, Gastro Sciences team and the Critical Care team by talking his multiple problems that needed immediate medical intervention
The team of doctors was presented with a huge challenge when Yaima Singh came with multiple complications. He had 99% blockage in the main artery of the heart and concurrently had a bleeding ulcer in the stomach and a tumor in the large intestine..
The patient, was rushed to a local hospital in Imphal following an unprecedented onset of chest pain. The doctors there diagnosed him to be having a heart attack and the patient was started on treatment including blood thinners. However, when the patient started passing blood in his stools he had to be stopped from the blood thinners. Consequently, he started having chest pain again and was brought to Flt. Lt. Rajan Dhall Fortis Hospital for further management.
A study conducted in Manipur on the distribution of risk factors for cardiovascular disease, according to the 10-year cardiovascular risk level, that is, low, moderate, and high. 29% overweight patients were at high risk and 20% were at moderate risk for CVD in the next 10 years. Among the patients who had high probability for the incidence of CVD in the future 10 years, 74.2% were hypertensive and 22.6% were pre-hypertensive while for those with moderate probability, 63.3% were hypertensive and 33.3% were pre-hypertensive.
The first surgery planned was the coronary angioplasty and stenting to LAD to treat the blocked artery in the heart. Besides a staggering 99% LAD blockage (the biggest vessel) in the heart the patient also had a very low haemoglobin level. The stenting procedure had to be conducted to open the blocked artery of the heart. The doctors were now facing a dilemma. The initial course of treatment needed the doctors to give blood thinners to the patient to keep the heart artery open but this would lead to more internal bleeding. Stopping the blood thinners, on the other hand, would put a strain on the heart. The team adopted the first line of treatment of 96 hours on infusion to heal stomach ulcer to reduce bleeding.
The patient had to then go through Endoscopy and Colonoscopy to determine the extent of the ulcers and the tumor. The upper tract in the colon had some ulcers and the lower tract revealed a large growth in the large intestine. Without any blood transfusion, Dr. Wadhawan’s team conducted the surgery for colonic malignancy after two weeks on blood thinners.
The performance of two surgeries in a span of two weeks on a 70 year old man is what made the case even more challenging.
Yaima Singh was then readmitted for a right extended hemi-colectomy under general anesthesia. The procedure was successful with special precautions taken during the procedure by using advanced energy sources and staplers as he was on blood thinners that could not be stopped. The procedure and the recovery were uneventful without use of a single blood or blood products.
Dr. Ripen Gupta, Sr. Consultant, Department of Cardiology, Fortis Flt. Lt. Rajan Dhall Hospital, said, “It was indeed challenging to treat a patient of 70 years with multiple problems that could be life threatening if not treated . When there is a blockage in the artery and also bleeding inside , the management of such a medical condition can be unnerving. But the team worked tirelessly to ensure that the patient suffered no other complications while being treated. Now, the patient is as good as any normal person and can lead a healthy life.”
Dr. Randeep Wadhawan, Director – General Surgery, Fortis Flt. Lt. Rajan Dhall Hospital said, “In a bloodless surgery, the doctors have to ensure minimal loss of blood. At the same time we also had to ensure that due to platelets the coagulation does not happen at the regular rate as this would have led to heart blockage again. We had to therefore, let the blood flow normally without any coagulation while treating the colon. To balance this delicate situation we adopted the Dual anti-Platelet therapy. With this we had only one problem to deal with and that was controlling any excess blood loss which was successfully done. The patient will now have to follow healthy diet patterns with a few restrictions for better management of his heart and non-recurrence of the ulcers.”
Mr. Abrarali Dalal, Facility Director, Fortis Flt. Lt. Rajan Dhall Hospital said, “Almost 60 – 70 percent of the heart patients who come to our unit are LVD patients. But this patient with multiple ailments posed a really big challenge for the team. I Congratulate to the team of doctors who worked very hard and closely to granted him longevity to his life through their perseverance and toil.”
Yaima Singh’s family expressed their deep gratitude to the team of doctors and said, “When we heard of his multiple problems we almost lost hope that there would be a turn around to his condition. But the doctors have worked really hard in restoring his life to him. We are very thankful to every doctor who has contributed to his life.” Today, Mr. H Yaima Singh is a happy man having solved both his life threatening conditions while adding years to his life.
About Fortis Healthcare Limited:
Fortis Healthcare Limited is a leading integrated healthcare delivery service provider in India. The healthcare verticals of the company primarily comprise hospitals, diagnostics and day care specialty facilities. Currently, the company operates its healthcare delivery services in India, Singapore, Dubai, Mauritius and Sri Lanka with 55 healthcare facilities (including projects under development), approximately 10,000 potential beds and 270 diagnostic centres. In a global study of the 30 most technologically advanced hospitals in the world, its flagship, the Fortis Memorial Research Institute’ (FMRI), was ranked No.2, by ‘topmastersinhealthcare.com, and placed ahead of many other outstanding medical institutions in the world.
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