United Arab Emirates : Zulekha Hospital Sharjah recently saved an expat, Laurence Anthony, a 42-year Philipino who rushed to a hospital in Fujairah with chest pains and was diagnosed with recent onset myocardial infarction NSTEMI, where he was transferred immediately to the CATH lab and was diagnosed with three critical issues and each required immediate surgical intervention.
He was diagnosed as having a critical coronary left main disease, a total block of the left anterior descending Artery and diagonal and circumflex branches. The Ascending Aorta showed a huge dilatation and a tear in the aortic wall that divides the normal single lumen into 2 channels (a true and a false one) and this makes the Aortic wall liable for rupture at any moment (Aneurysm and Chronic Aortic Dissection).
Dr. Mohamed Ahmed Helmy, Professor and Consultant Cardiac Surgery shared, “Operating upon such a patient involves very high risk with 20 percent mortality and morbidity according to the STS American risk score, and the complex procedure required the patient to be transferred to a super specialty hospital. Our CTVS team at Zulekha Hospital Sharjah is well experienced in dealing with similar cases and hence the patient was transferred by ambulance to our hospital ICU with prompt preparation and preoperative investigations in the form of laboratory and radiologically multislice CT angio.”
“Mr Laurence is married and has one daughter and as a breadwinner, it was imperative to get him back on his feet.” he added.
Dr. Helmy planned for the replacement of the Ascending Aorta and Aortic valve replacement and CABG 3 bypass using LIMA to LAD (internal thoracic Artery to the Left Anterior Descending artery) CABG 3 bypass. The surgery was successfully performed with smooth weaning from the cardiopulmonary bypass. Due to the complexity of the pathology and previous intake of antiplatelet drugs before performing the Coronary angiogram, Hemostasis (stopping the blood flow) was not an easy part of the operation.
The patient was then transferred to the ICU and the first 24 hours was the most critical period after which the patient was weaned from the ventilator and the inotropes and discharged from the hospital on the 8th postoperative day.
The operation was performed by Dr Helmy, alongside his cardiovascular team including Dr Abhijit Sen Specialist Anethetist, Dr Ganesh Somasundaram, two perfusionists, Jysna and Prajetha, Specialist Cardiovascular Surgeons Dr Wael Lutfi Al Richane and Dr Hasan Al Shaiah, and the ICU team including Specialist Critical Care Medicine Dr Islam Essam Eldin Elkousy and Consultant ICU Dr. Maged Abdulmagd who played a crucial role.
Lawrence extended his gratitude to the team at the hospital, saying “My heartfelt thanks to all the doctors and team for having sensitively managed my entire criticality. I have a new life by God’s grace.”
The major cause of this complex disease is neglected Hypertension and Hypercholestermia (high blood cholesterol level).
Dr. Helmy advices, “Every one must check their blood pressure and blood cholesterol regularly in patients above 40 years and in diabetic patients, and check earlier for those who have a positive family history.”
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