Times of India
30 March 2010
By Radha Sharma
Ahmedabad, India

The circulation was stopped for nearly 20 mins to remove clots from his lungs
Doctors in the city recently performed a rare surgery on a 45–year–old man when they removed clots from his lung vessels by stopping blood circulation for 20 minutes and cooling his body to 18 degrees Celsius. The normal temperature is 37 degrees. The clots were being pumped into the lungs from his leg veins.

The challenging surgery, which lasted eight and half hours, was performed on Nishith Raval, an ex–defense personnel, by cardiac surgeon Dr Apoorva Kanhere at the Apollo Hospital, Bhat.

“The surgery is done on the heart–lung machine by cooling the body to 18 degrees and then stopping the entire blood circulation so as to get a clear field for surgery. The cast of clots that lined the right side of the pulmonary artery was removed during a blood circulatory arrest period of 17 minutes while the clots were removed from the right side by stopping the circulation for 19 minutes,” said Kanhere.

Kanhere said the surgery has been successfully done for the first time in Gujarat. He had seen the surgery being performed a decade ago in Australia and decided to attempt it on Raval as his condition was critical and not responding to medication. So far, only two hospitals in Bangalore and Chennai have done the surgery in India.

Raval, father of three daughters, had almost given up mentally which caused constant breathlessness, swelling in his limbs and his stomach that protruded outwards due to accumulation of water. Even local doctors in Surendranagar had told him there was little they could do for his problem.

In fact, much time was wasted in wrong diagnosis as Raval, who had undergone a varicose veins surgery 18 years ago and also another to treat Deep Vein Thrombosis (DVT), was treated for symptoms like accumulation of water in stomach and breathlessness.

That the clots shot from his legs into the lungs were clogging his lung arteries leading an abnormally high lung pressure and thus causing symptoms like acute breathlessness, swelling, water retention in stomach was diagnosed by cardiologist Dr Sameer Dani, head cardiology at Apollo Hospital.

“Life expectancy after diagnosis of chronic thromboembolic pulmonary hypertension, which Raval has, with maximum medical treatment is less than 15 per cent at 5 years. With a successful pulmonary thromboendarterectomy, the five year survival is more than 80 per cent,” said Kanhere.

Dani said that Raval will be put on life–long anti–clotting medication so that new clots are not formed. “Moreover, a filter will also be placed in his inferior vena cava to trap any small clots that may form in his legs despite anticoagulant drugs,” he said.

“I never thought I will live but it seems prayers of my wife and daughters have been answered,” said Raval who is known to have a positive attitude towards life.