Case Study: First time in India, Fortis docs repair leaking heart valve without surgery

Doctors led by Dr Ashok Seth avoid open heart surgery by using the catheter based procedure Mitraclip


For the first time in India, a team of doctors led by Dr Ashok Seth, have successfully performed the catheter based procedure of MitraClip to repair a leaking heart valve without surgery at the Fortis Escorts Heart Institute. They were supported by Professor Saibal Kar from Smidt Heart Institute, Cedars Sinai Medical Centre, Los Angeles.

The patient was a 69-year old man who was suffering from repeated heart failure. His condition was such that open heart surgery was not possible. The patient had a previous bypass surgery 13-years ago. Of late his heart had been getting enlarged due to a severely leaking valve leading to breathlessness and heart failure. Till now, open heart surgery with repair or replacement of the valve had been the only possible treatment for such patients in India but it is often high risk.


Dr Ashok Seth, Chairman, Fortis Escorts Heart Institute said, “The MitraClip is a novel catheter based non-surgical repair of the mitral valve inside the heart and is performed in the Cath Lab like angioplasty. Special catheters are inserted through the large vein in the groin and the catheter is passed from the right chamber of the heart to the left chamber of the heart by puncturing the partition called interatrial septum.  Then under echocardiography and X-ray guidance a clip is put on the leaking mitral valve to decrease the leak which improves the condition of patient. The patient is normally ready to be discharged in 24-48 hours’ time.”

Mitral valve is the valve connecting two chambers of the left side of the heart that receives impure blood from all over the body and then sends it ahead to the lungs for purification.

Professor Saibal Kar of Smidt Heart Institute, Cedars Sinai Heart Centre, Los Angeles said, “Recently the COAPT trial, published in the New England Journal of Medicine, demonstrated the benefits of MitraClip procedure not only in improving the wellbeing and symptoms of the patient but also improving the survival of patient over 2-years.  With the introduction of MitraClip to India, we hope to benefit a number of patients who are gradually deteriorating from leaking valves, despite medications and are unsuitable for valve replacement surgery.”

MitraClip mitral valve repair without open heart surgery is one of the innovative scientific advancements of recent times.  A few years ago, it was hard to imagine that a valve which lies within the heart could be repaired by catheters, through an angioplasty like procedure without opening the heart and putting the patient on cardiopulmonary bypass.  A leaking mitral valve affects nearly 10% of the population who have coronary artery disease, heart attacks or bypass surgery and continues to increase with age. The continuously leaking valves put pressure on the heart causing breathlessness.

If left untreated, it leads to enlargement of the heart, heart failure and death.  These patients are either at a high risk for valve surgery or do not benefit from it.

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Case Study: 18-hour Baby Undergoes Open Heart Surgery at Fortis Escorts Heart Institute

Image IIFortis Escorts Heart Institute (FEHI) conducted an emergency open heart surgery on an 18 hour new born baby, the youngest reported case in the country till date. The surgical team of doctors was headed by Dr. K S Iyer, utive Director- Paediatric & Congenital Heart Diseases at FEHI.

The baby, Mayank Agarwal, was born with a heart defect called the Obstructed Critical Total Anomalous Pulmonary Venous Connection (TAPVC). TAPVC is a medical condition in which the blood does not take the normal route from the lungs to the heart and out to the body. Instead, the veins from the lungs are attached to the heart in abnormal positions. The abnormal vein is also narrow and blood tends to dam up. The oxygenated blood enters or leaks into the wrong chamber and blood gets dammed in the lungs. The blood passing through the aorta to the body does not have normal amount of oxygen, which causes the child to become breathless and look blue. The only option is an emergency surgery to avert fatal consequences.

The baby was born in the city of Mathura and within minutes of his birth was declared to have severe breathing difficulty. After being in two local hospitals in Mathura, the local doctors were still unable to treat the baby and asked the family to rush the child to a multi-super specialty hospital in Delhi. Upon the refusal of the hospital in Delhi, the child was subsequently referred to Dr. Iyer at FEHI. A decision to perform an Open Heart Surgery was taken which involved cutting the chest open and performing the surgery on the muscles, valves, or arteries of the heart.

Dr. K S Iyer, utive Director, Paediatric & Congenital Heart Diseases, FEHI said, Rapid advances have taken place in the diagnosis and treatment of paediatric congenital heart defects over the last few decades. There are diagnostic tools available today by which a more accurate diagnosis can be made even before birth. With currently available treatment modalities, over 75% of infants born with critical heart diseases can survive beyond the first year of life and many can lead near normal lives thereafter. However, the key is early diagnosis and timely intervention. Added Dr Iyer, This child was born with an additional defect of abnormal and narrow veins that posed a bigger challenge as the veins had to be treated immediately.

Dr. S. Radhakrishnan, Director & HOD Paediatric & Congenital Heart Disease, FEHI said, Treating a patient as young as this is a huge challenge, starting with anaesthetic challenge on the onset of the procedures itself. Even when the surgery is successful, the challenges are not over as post-surgery the chest had to be kept open for three days to keep the new born under dedicated observation for any emergencies. Currently, the baby is showing normal growth as any three month old would and we expect that it would continue with timely check- ups and regular follow-ups.

At the time of this surgery for TAPVC, the pulmonary veins are reconnected to the left atrium and the atrial septal defect is closed. The child will need regular follow-up with a paediatric cardiologist and, once the child reaches adulthood, lifelong regular follow-up with a cardiologist with special training in congenital heart defects. Follow-up is needed to make certain that any remaining problems, such as an obstruction in the pulmonary veins or irregularities in heart rhythm, are treated.

Dr. Somesh Mittal, Zonal Director, FEHI said, Fortis Escorts Heart Institute is the first hospital with a specialised multi-disciplinary team of Paediatric Cardiologists and Paediatric Surgeons. Our trained team brings a vast experience; pioneered several cardiac techniques for children and has produced results that are comparable to the best in the world. The Paediatric & Congenital Heart Diseases team at FEHI has performed a record of over 13,000 heart surgeries on infants and children over the last two decades.  This challenging open heart surgery performed on the new born further highlights the expertise and skills of our doctors.

Congenital heart diseases (CHD) refer to structural or functional heart diseases, which are present at birth. The total live births in India are estimated at nearly 28 million per year.  The reported incidence of congenital heart disease is 8-10 per 1000 live births in the world and in India 6-8 per 1000 live births. Nearly 33% to 50% of these defects are critical with nearly 180,000 children are born with heart defects each year in India requiring intervention in the first year of life itself. Of these, nearly 60,000 to 90,000 suffer from critical cardiac lesions requiring early intervention.

Gopal Agarwal, a resident of Mathura and father of the infant, expressed his gratitude, I have no words of gratitude for Dr. Iyer and his team. After 28 years, we experienced the joy of the birth of a baby in my family and it was a happiness that we almost lost. Despite the time that we lost in reaching Dr. Iyer, he immediately started the corrective procedures on my baby. I am so grateful to have come to Dr. Iyer who restored the joy and happiness in my family.

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Case Study: 1 month old child from Kenya undergoes open-heart surgery at Fortis Escorts

A team of Fortis Escorts Heart Institute surgeons under Dr K S Iyer has performed open-heart surgery on baby suffering from multiple heart ailments.

NEW DELHI: A one month-old baby from Kenya has successfully underwent an open heart surgery at Fortis Escorts Heart Institute (FEHI) in New Delhi.

The baby of one Yusuf Mohammad had been suffering from multiple heart ailments including transposition of great arteries, VSD (ventricular septal defect) and PDA (patent ductus arteriosus), the hospital said in a release.

Transposition of great arteries is a medical condition where the lung and heart arteries are switched at birth.

A surgical team of doctors at the FEHI’s centre of excellence in paediatric cardiac centre, headed by Dr K S Iyer, conducted the operation.

Dr Iyer, executive director, pediatric & congenital heart diseases, at FEHI, said such a surgery is a challenge in India and elsewhere.

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Case Study: M6 Cyberknife treatment saves 78-year-old male with lung cancer

New Delhi, 78 year old Mr. A was taken aback when a small spot in the right lung on chest X ray turned out to be adenocarcinoma ( a type of cancer) after the biopsy. He had a number of associated health problems – COPD, diabetes, heart disease for which he had undergone bypass surgery 8 year back. He was considered very high anesthetic risk. He was advised surgery for the cancer, however due to the high anesthetic risk, he was not a suitable candidate and surgery was ruled out. He then heard about Cyberknife treatment for lung cancer and opted for it. He underwent 3 sessions of treatment and his PET CT scan 3 months later is showing that the tumor has reduced by about 75%. How common is lung cancer in India? Lung Cancer is one of the most common cancers in India and has emerged as Global Killer. According to the GLOBOCAN 2012 report – Lung cancer ranked fourth overall among the various types of cancer in India; in males, it ranked second while in females it was sixth in terms of cancer incidence. The incidence of lung cancer is increasing each year with the trends in India following its global counterpart. With time, there has been a better understanding of the biology of the disease, with screening protocols put in place to detect the signs of lung cancer at an early stage. Most lung cancers in India are detected at a stage when it has spread beyond the lung into the lymph nodes or other organs. Statistically, only 16% are diagnosed when confined to the local site, which signals early stage disease. Lung cancer has good cure rates when detected early. This is reflected in the 5 year survival rate for lung cancer which is around 56 % for localized disease, and 30% for disease which has spread to the nodes says Dr. Jayalakshmi Sr. Consultant Radiation Oncology, Artemis Hospital, Gurugram Who is the main culprit? The primary risk factor for lung cancer is smoking tobacco, which accounts for most lung cancer related deaths. Cigarette smoke contains many cancer producing chemicals like nitrosamines and benzopyrenes. The risk for lung cancer increases with the number of packs of cigrattes smoked per day, and with the number of years spent smoking. Exposed non smokers also have an increased relative risk of developing lung cancer from second hand smoke. Stopping smoking brings down the risk of developing lung cancer. The decline is overall risk following stopping of smoking (called cessation) starts within 2-5 years of stopping smoking especially in people below 50 years of age. What are the treatment options? Surgery remains the gold standard of treatment in early stage lung cancers. However, there has been a search for nonsurgical, but curative treatment, more so in patients who are medically inoperable (that means the cancer as such is operable, however the patient cannot undergo surgery due to anesthetic risk), and in patients with a small tumour which has recurred (come back) after prior treatment. These are patients who earlier hit the dead end – now , Cyberknife treatment ( called SBRT or SABR in lung) is an easy, non invasive therapy available with proven and equal efficacy in these patients. The effectiveness of Cyberknife treatment has made it a treatment option in early stage node negative non small cell lung cancers who are medically inoperable and has been incorporated into NCCN protocols. Why M6 Cyberknife is preferred? The CyberKnife system is a method of delivering radiotherapy, with the intention of targeting treatment more accurately than standard radiotherapy. It consists of two main components : Linac which produces the radiation, and  a robotic arm which allows the energy to be directed at any part of the body from any direction. CyberKnife radiation surgery is the most advanced, non invasive radiation therapy tool available to treat cancerous as well as non cancerous diseases with the help of precise beams of high-dose radiation. It is a no pain and a no risk day-care treatment wherein patients are discharged as soon as the session gets over and therefore, no hospitalisation is required. The treatment uses a sophisticated image guidance system to beam high doses of radiation directly to your tumor. The CyberKnife radiation therapy works the best for tumors that are upto 3cm in size. Cyberknife radiosurgery is a very powerful and precise radiation technique, for patients with early stage primary, medically inoperable lung cancer. The treatment is safe to administer and also offers a new option in patients with recurrent disease or a single metastatic disease in the lung. The Cyberknife-M6 device is uniquely designed to deliver  an accurate and exact radiation dose to a moving cancer target in the chest ,while preserving the maximum possible adjacent tissue ,making it an ideal device to treat lung cancer patients. The CyberKnife-M6 device is the only radiosurgery or radiotherapy device that tracks and treats a moving cancer throughout the entire breathing cycle. This enables an even smaller margin of normal tissue around the cancer to be treated, increasing the safety of treatment. How does M6 Cyberknife work? Treatment with CyberKnife is phased. Imaging is performed few days in advance in a process called planning, thereby leaving the radiation oncologist with enough time to design and finalise a customised treatment plan. Once the plan is set in place, the patient will return for a non-invasive, pain-free treatment experience. Using advanced tumor-tracking technology, the CyberKnife system is able to deliver either one single high-dose treatment, or smaller doses (upto 5) over the course of two to five days, depending on the plan generated. This approach limits side effects and enables most patients to return to their regular routine the same day. The best part of Cyberknife treatment in the lung is the synchrony based tracking and treatment feature. This means that the tumour is tracked throughout the breathing cycle, and treated exactly at its position in the lung, even as the lung moves with respiration, thus causing the tumour also to move. Additionally, there is no necessity for complicated techniques like holding the breath in order to achieve such accuracy. The Cyberknife treatment in lung is done in the course of normal breathing cycle, yet achieving an accuracy of less than a millimeter,  called sub millimetric accuracy).Nothing is required of patients during treatment with CyberKnife, except to relax and breathe as normally as possible. However, the cyberknife also has an autostop feature if your breathing is suddenly varied and heavy. The treatment will start again only when the breathing returns to normal, in order to ensure total accuracy. Each session of treatment usually lasts for about 45 min to 1 hour. The treatment is usually completed in three to four treatment sessions, over a week’s time. It is a cost effective treatment with a 5 year local control of 92.6% in early stage lung cancers.

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Case Study: Cyberknife surgery saves 32-year-old female with Acoustic Neuroma

Indu, a young 32-year old housewife noticed whistling sounds in her left ear 1 year before she consulted her physician in Agra. One thing led to another, and an MRI scan of her brainshowed a benign tumor involving her hearing nerve, an Acoustic Neuroma. The gradual growth of the tumor in the main nerve leading from the inner ear to the brain started causing balance and hearing complications.

But the symptoms being mild in the beginning, she thought it to be some kind of weakness and ignored it. Later due to the pressure build up by the tumor started causing whistling sound in her left ear and led to unsteadiness. Her neurosurgeon advised her to undergo open surgery. Being confused and worried with the doctors’ statement she wanted to wait for sometime as she was not mentally prepared for the surgery. This delay led the tumor to grow further affecting the adjacent nerves that control facial muscles and other vital brain functions.

With constant dizziness and hearing problem she was then airlifted to Artemis Hospital Gurugram, where immediate attention was given to reveal that the complication had worsened.  MRI revealed that the tumor had grown large enough to compress the brain stem and the condition now was life threatening due to fluid build-up in her skull.

The team decided to use M6 cyberknife, which is a non-invasive radiosurgery technique. And within half an hour the lady was completely treated without any risks or complications. She was discharged the same day and went back home to her normal daily activities. There were no risks, scars, no pain, no ICU stay or a week stay in the hospital, and no anxious husband waiting outside the operating room. Now, her MRI scans done later have shown us that this treatment was a cure, and her hearing remains the same.

The above case shows that CyberKnife radiosurgery system used as an alternative to surgery, or in conjunction with other treatments plays a significant role in the management both non-cancerous and cancerous brain tumors.

The technique that has been around in India for about 3-4 years has been mostly used to treat a range of cancerous and non cancerous/benign tumors in the body including the prostate, lung, liver, etc., is now being commonly used to kill tumors of brain and spine as well.

What is CyberKnife?

Basically, CyberKnife radiation surgery is the most advanced, non invasive radiation therapy tools available to treat especially non-cancerous as well as cancerous and other diseases with the help of precise beams of high-dose radiation. It is a no pain and a no risk day-care treatment wherein patients are discharged as soon as the session gets over and therefore, no hospitalisation is required. The treatment uses a sophisticated image guidance system to beam high doses of radiation directly to your tumor.

The CyberKnife radiation therapy has clinically proven success rates, however, it works the best for a tumors that’s upto 2-2.5 cm in size. However, in a few rare cases it is also used as an treatment option to cure brain tumors that either cannot be operated because of their location in the head, or the patients who cannot undergo brain cancer surgery due to their poor medical condition, etc.

The next generation of CyberKnife – M6 is highly precise when compared to the earlier ones used in India as this offers some of the exceptional features and delivers a maximum dose of radiation directly to the tumor from many different angles with sub-millimeter precision for the higher success rates. Also, the emitted focused beams of intense energy destroy cancercells and shrink/control the growth of tumors. It further prevents the cancerous cells from multiplying. Infact, the objective of radiation therapy is to destroy the harmful cells while minimising damage to healthy cells.

Besides, the CyberKnife system automatically adjusts itself and tracks the tumor which aids in minimising radiation exposure to healthy organs and tissues. The CyberKnife radiation surgery offers multiple benefits compared to conventional radiation treatments and surgery.

Cyber Knife Vs conventional Gamma Knife 

For brain tumor or cancer patients, Gamma Knife treatment is not as convenient or comfortable, largely because Gamma Knife requires an invasive head frame be bolted into the skull. Compared to this, the CyberKnife is a non-invasive, real-time motion tracking technology for accurate delivery of high-dose radiation therapy. Instead of a bulky head frame, CyberKnife patients are provided with a soft, mesh mask during the treatment.

Moreover, treatment with CyberKnife is flexible; imaging is performed few days in advance, thereby leaving the radiation oncologist with enough time to design and finalise a customised treatment plan. Once the plan is set in place, the patient will return for a non-invasive, pain-free experience. Using advanced tumor-tracking technology, the CyberKnife system is able to either deliver one single high-dose treatment, or smaller doses (upto 5) over the course of two to five days. This approach limits side effects and enables most patients to return to their regular routine the same day. Additionally, clinical studies have shown that patients with certain cancerous and non-cancerous conditions in the brain, neck and spine have a better outcome with a lower dose of two to five fractionated radiation treatments than a single, large dose.

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Case Study: Cyberknife surgery saves 30-year-old female with rare spinal cord tumor

30 year old housewife was successfully treated at Artemis Hospital recently. She had been suffering from a rare spinal cord tumor for over 6 months, which was persistently troubling her daily chores and could have left her paralyzed.
“Even though the tumor was in stage 1, if left untreated, it would have left her paralyzed from one side. Such tumors are benign in nature and are very rare, with only 0.5 – 1% of the population being affected. Keeping in mind the size and location of the tumor, which would have been risky to treat with conventional radiotherapy, the team decided to perform cyberknife robotic surgery. The procedure took 40 minutes and the patient was discharged immediately. Radiographic reports revealed that the tumor had subsided completely after the first session without affecting the healthy cells.” Says Dr Aditya Gupta, Director, Neurosurgery and Cyberknife Centre, Agrim institute for neuro sciences, Artemis Hospital
The patient had always been ignoring the aggravated pain in her left shoulder for months. Being a mother of two, she thought the pain was due to exertion, but she had been in consistent and unbearable pain that led to difficulty in walking at times. It was only then, when she started paying heed to. She started losing sensation in her arms and legs.
“Even though conventional surgery was kept as an alternative, but had a mild risk on patient getting paralysis and hence was not advisable. This is where cyberknife is effective and a safer treatment option. Being a non-invasive and pain free procedure, the tumor was completely removed with high dosage of targeted radiation.” Added Dr Gupta
Early diagnosis is an important factor in the outcome of spinal cord tumors. Though many other treatment methods may be available for treating spinal tumors but due to the advantage of being totally non-invasive and eliminates the requirement of any kind of anesthetics, cyberknife is a very useful tool saving the patient’s time and helping in better and quicker recovery.
Treatment for spinal tumors remaining a challenge in India, due to the reason that only limited technology is available, and also the fact that the spine is sensitive and can receive only limited amount of radiation. Cyberknife being flexible in producing radiations is one of the best options for treatment of spinal tumor.

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Case Study: Cricket ball-sized tumour removed from woman’s heart


Noida: A 48-year-old woman from Ghaziabad recently had a cricket ball-sized tumour removed from heart tumour removed from heartat a private hospital in Noida. A heart tumour is a rare phenomenon, doctors at Fortis Hospital in Sector 62, where she underwent the surgery, said. The success rate for such a surgery is 25 percent.

Poonam Choudhary, the patient, had difficulty in breathing and also suffered from chronic cough. She visited two hospitals in Ghaziabad about a month ago.

“The doctors said that they would not be able to cure her and suggested that we should take her to a bigger hospital for treatment,” Rajbir Teotia, Poonam’s husband said.

On April 15, an ECG conducted at Fortis Noida revealed that a tumour, 7×8 sq cm in size, covered the upper left chamber of her heart. It affected blood circulation and limited the cardiac function to 25 per cent, according to doctors. It also affected the functioning of patient’s lungs and liver, doctors said. She underwent the surgery on April 18 and was discharged on


“It was a tough surgery as the tumour was huge in size. It could have got fragmented during the operation with segments reaching other organs if the surgery would have gone wrong. Moreover, the tumour was compressing major structures, and it became difficult to establish the cardiac pulmonary bypass,” Dr Vaibhav Mishra , senior consultant, department of cardiothoracic and vascular surgery, Fortis Hospital, said.

After the three and a half hour long surgery which cost around Rs 3.25 lakh, the cardiac function has increased up to 50 per cent. She would take six months to recover from the surgery, said doctors.

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Case Study: Doctors at Fortis Hospital Remove Giant Tumour from the Chest of a 31 year Patient

A team of doctors from Fortis Hospital, Noida has removed a giant neurogenic tumour from the chest of a 31 year old patient in a lifesaving operation that lasted five hours.

The neurogenic tumour, arising from nerves within the patients chest, had grown to an enormous size. The surgery was led by Dr Vaibhav Mishra, Senior Consultant, Cardio Thoracic and Vascular Surgery, with support from Dr Manish Vaish, Senior Consultant, Neurosurgery and Dr Vipin Goyal, Senior Consultant, Anaesthesiology.

Mayank Nauni exhibited symptoms of severe chest pain. The diagnosis revealed a giant neurogenic tumour or Posterior mediastinal tumour in the chest, the size of a large coconut weighing seven kilograms. The resulting pressure, due to displacement and compression of the heart, major blood vessels and the food pipe, was intense as the tumour pressed against these organs. Arising from a Spinal nerve root, the tumour had eroded the vertebral body. These tumours are extremely uncommon and can be hereditary or caused by developmental malformations. They usually occur in patients aged 30 to 50 years, but can develop at any age.

Mediastinal tumours can be benign or cancerous growing in the area of the chest that separates the lungs. This area, called the mediastinum, is surrounded by the breastbone in front, the spine at the back, and the lungs on each side. Surgery in such cases is extremely challenging particularly if the patient has a muscular built. Other concomitant risks arising from the tumour include damage to major structures like the heart, aorta, food pipe and spinal cord as the tumour adheres to these structures. The expertise of the doctors was evident as no blood transfusion was required by the patient during the surgery.

Research reveals that five out of 41 (12%) patients have neurogenic tumours. Intra-thoracic neurogenic tumours occur predominantly in the mediastinum (90%). It is often impossible to establish the benign or malignant nature of these tumours, prior to surgery. Therefore, a wide surgical resection remains the cornerstone of such treatment and often requires the co-operative efforts of a multidisciplinary team of thoracic, plastic, and neurosurgeons.

These tumours are quite rare, and when they are of this size, they are termed Giant Schwannomas. The biggest challenge is to remove them completely, without causing collateral damage to neighbouring organs. Despite the odds, we were able to remove the tumour successfully minimizing the chances of any recurrence, said Dr Vaibhav Mishra, Senior Consultant, Department of Cardio-Thoracic and Vascular Surgery.

The tumour was arising from one of the nerves originating from the spinal cord. It was eroding the vertebral column and if not removed in time, it could have led to major complications including compression of vital structures, nerve palsy, malignant changes, extreme weakness or paralysis of the lower limbs. said Dr Manish Vaish, Senior Consultant, Neuro Surgery.

Such an operation requires tremendous expertise and great teamwork. We are confident of treating such complex cases and hope to continue to offer newer and better clinical modalities with predictable outcomes and high success rates, said Gagan Sehgal, Zonal Director, Fortis Hospital, Noida.

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Case Study: Bangladeshi senior citizen survives life threatening abdominal aortic aneurysm at Fortis Malar

Swollen abdominal aorta with multiple angulations treated successfully

Chennai, 11th September 2018: A team of vascular surgeon and cardiac anesthetist from Fortis Malar Hospital recently performed a challenging endovascular aneurysm repair on a 69 yrs. Old man from Bangladesh. The timely treatment and meticulous procedure saved Mr. Ananta Kumar Saha who was in critical condition as his abdominal aorta was in high risk of rupture. This challenging procedure was successfully executed by Dr. Balakumar S, Senior Vascular Surgeon, Fortis Malar Hospital.

Mr. Saha, a hardware salesman from Bangladesh , has been experiencing pulsating mass in his abdomen for the past 20 years, and the intensity had increased over the last two months. The patient was admitted to Fortis Malar and diagnosed with an abdominal aortic aneurysm. His ballooned abdominal aorta was 9 cm (normal 1.6cm) with 90 degree turns and twists at three levels, resulting in a very high chance of rupture and instant death.

Following an evaluation, the patient was taken for Endovascular Aneurysm Repair (EVAR). EVAR is a minimally invasive procedure wherein both the femoral arteries in the thighs are opened with a very small incision and a stent graft is inserted, excluding an aneurysm thereby preventing rupture. Due to multiple angulations which were along the course of the blood vessels from the heart to the legs, the exact and precise placement of the stent graft had to be meticulously executed by the doctors to prevent leak and clot migration.

Speaking on the surgery, Dr. Balakumar S said‘Abdominal Aortic Aneurysm cases could be very risky as once the aorta ruptures, it could lead to instant death. Prevalence of Abdominal Aortic Aneurysm is about 5 to 16% in men older than 65 years. But the dilatation of blood vessels occurs earlier and will be asymptomatic in most patients. The rupture rate is 20% for 5years if size is above 5.5cms causing instantaneous death. Therefore, screening by simple Ultrasound Abdomen becomes essential in men over 50 years with risk factors such as diabetes, elevated blood pressure, increased cholesterol values, obese individuals and patients with known coronary artery disease. Failure of early screening would result in detection of aortic aneurysms with complications like contained rupture and at times rupture leading to inevitable loss of precious life.’

‘I am very happy that we came to Fortis Malar. Our hope increased after we met Dr. Balakumar. I no more feel the pulsating mass in my abdomen and I am very thankful to the team of doctors who performed this surgery successfully.’ said Mr. Saha.

An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. Because the aorta is the body’s main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding. The likelihood that an aneurysm will rupture is influenced by the size, expansion rate, continued smoking and persistent hypertension.

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, Dubai, Mauritius and Sri Lanka with 45 healthcare facilities (including projects under development), approximately 10,000 potential beds and over 368 diagnostic centers.

About Fortis Malar Hospital:

Fortis Malar Hospital was acquired by Fortis Healthcare (India) Limited in early 2008. The hospital founded in 1992, is established as one of the largest corporate hospitals in Chennai providing quality super specialty and multi-specialty healthcare services. Fortis Malar Hospitals, with 180 beds, focuses on providing comprehensive medical care in the areas of Cardiology and Cardiac Surgery, Neuro Surgery, Gynaecology, Orthopaedics, Gastroenterology, Neurology, Paediatrics, Diabetics, Nephrology, and Internal Medicine. Fortis Malar Hospital has a state of the art Cath Lab and multiple dedicated cardiac operation theatres and intensive coronary care units. Several rare and complex Adult and Paediatric Cardiac surgeries, Orthopaedics and Joint replacements, Neurosurgeries and Plastic reconstruction surgeries have been performed at this hospital. The hospital’ Obstetrics and Gynaecology services are among the busiest in the city, successfully performing many complicated deliveries and surgeries. They are supported by a dedicated Neonatology unit.

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Case Study: Mohali hospital gives new lease of life to 43-year-old Zimbabwe patient

MOHALI: The Fortis Hospital, Mohali gave a new lease of life to a 43-year-old Zimbabwepatient, Priscilla Jaramba, by successfully conducting an intricate heart valves surgery, which was badly inflicted by the valve infection called ‘Valve Endocarditis.


The surgery was successfully performed by a team lead by Dr T.S Mahant, Executive Director of Cardiothoracic & Vascular Surgery, who successfully replaced Priscilla’s two damaged heart valves at Fortis Hospital here.


Dr Mahant while giving the information said that “Priscilla was brought up in a very serious condition.


The infection had badly inflicted her two heart valves and made abscess in her heart, which later could have spread and caused damage to other organs too. And could have put her life to risk, which was found after carrying out investigations and examining the test. Immediately we performed surgery and successfully replaced her damaged valves and contained the infection which was spreading in the body”.


He added that it’s a common disease and its diagnosis is very difficult because of initial symptoms, which raise a body temperature and we often ignore it by treating a normal fever, which later turns into a chronic infection. The surgery is very risky and it depends on the condition of the patient. Its curable with drugs only at the initial stage but once it spreads and affects the valves, then surgery is imperative.”

It took 11 months to Priscilla to know about actual health problem when she came to Fortis Hospital on September 12 this year where a doctor diagnosed her with ‘Valve Endocarditis’ infection.


Being a nurse by profession in Zimbabwe, Priscilla narrated her experience and said, “From the beginning to the end, the whole procedure was very smooth. My health was in bad shape. I couldn’t breathe properly and hope was fading away. But after getting a surgery done here, I am feeling far better than before and it’s just because of Dr Mahant, his team efforts my life has been saved”.

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Case Study: Aster CMI in Bangalore, first in Asia to perform liver transplant using advanced technology

This addresses the key challenge of organs losing full functionality during long hours of preservation, often resulting in rejection after transplant

Aster DM Healthcare, a private healthcare services provider in Asia, announced recently that it has performed Asia’s first-ever liver transplant using Normothermic Machine Perfusion, a process which can keep a liver alive outside the body for up to 24 hours by maintaining it at body temperature.

The surgery – considered the next important step forward in liver transplantation – was successfully performed at Aster CMI Hospital in Bangalore using OrganOx Metra device technology. Aster CMI has become the only hospital in India and the wider Asia region to use the perfusion technique as part of its standard clinical practice which allows physicians to test how well a liver is functioning before transplant, boosting the chances the procedure will be a success.

The announcement comes at a time when the demand-supply disparity in India for organ transplant remains a critical issue, which is primarily attributed to lack of awareness and infrastructure. Furthermore, the organ transplant success rate in India is low compared to developed nations in the West, and often this is due to the functionality of organs deteriorating during the preservation stage that lasts up to 12-14 hours.

Speaking on the occasion, Dr Harish Pillai, CEO, Aster DM Healthcare, India, said, “What our physicians have performed at Aster CMI Hospital is a major milestone which will potentially hep us overcome some of the critical challenges our country face when it comes to organ transplantation. As we accumulate more experience in the technique, we are extremely confident that this can help improve the success rate of organ transplant in India and the wider Asia region.”

Ashwath, 53 years old who was suffering from end stage liver disease became the first person in Asia to receive a liver transplant using this state-of-the-art technology. Dr Sonal Asthana, Senior Hepatobiliary and Transplant Surgeon, said,“Livers are usually stored in ice and a preservation solution in a small sized box, where they can be kept for 12 to 14 hours before transplant. Sometimes, those less suitable for transplant do not survive the cold and begin to deteriorate, and this severely impacts the success rate of the organ transplant. The introduction of normothermic machine will change the way we preserve organs and allow us to check the functionality of organs before transplantation. Also, organs which are donated in far off parts of the country can now be transported to transplant centers and utilised safely.”

The new Organox Metra device has created a system that allows blood to circulate through the liver. When the organ is in the device that mimics the body, doctors can monitor the blood flow and letting out bile and can better tell how it might work in a patient. The technology has only been available in Europe and the US so far, and this is the first time it has been used in Asia at Aster CMI Hospital in Bangalore.

The ILC medical experts at Aster Hospitals specialise in all aspects of liver care such as liver transplantation, liver anesthesia, and liver pathology among others. The team of 11 has special training and extensive experience resulting from a collective expertise of over 2000 liver transplants and over 4000 major liver and pancreatic surgeries in major hospitals around the world.

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Case Study: Five-month-old girl gets new lease of life after liver transplant


A five-month old baby girl from Kolkata has become India’s youngest liver transplant patient, doctors at the Max Super Speciality Hospital .

New Delhi, A five-month old baby girl from Kolkata has become India’s youngest liver transplant patient, doctors at the Max Super Speciality Hospital said here on Tuesday.

Ariana Dey, now six-months old, was born healthy but at five-months of age she suffered from jaundice which led to her liver malfunctioning (elevated ammonia).

She was admitted to the hospital with acute bleeding and was advised a liver transplant, where her mother donated a part of her liver.

In a 10-hour-long surgery, the doctors replaced Dey’s malfunctioning liver with a modified liver from her mother to fit the baby.

“In baby Dey’s case, the transplant was required urgently as she was diagnosed with very severe liver failure and was in a critical state when she came to us. Our aim was to treat her at the earliest with a lifesaving surgery, ensuring her quality of life isn’t impacted in the long run,” Subhash Gupta, Chairman at the hospital’s Centre for Liver and Biliary Sciences, told IANS.

“After the surgery, she will lead a normal life. Dey is the youngest Indian to undergo successful liver transplant,” he added.

Highlighting the complexity of the surgery, the doctors maintained that conducting a liver transplant surgery in a baby weighing less than 10 kilograms and less than one-year-old is a very complex procedure.

“In infants, the surgical complexity is immense and post transplant care is specialised, given their small size. Usually, an adult’s liver weighs around 1.2 kg. The surgeons resected 182 grams of it and modified it to fit Ariana’s body size,” Sharat Varma, Consultant at the hospital, told IANS.

“Post transplant, Dey did well and showed rapid recovery. She went home within 22 days of surgery,” Varma said.

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