Doctors trigger heart attack to save patient
P Ram Kumar - Hyderabad

Doctors here have triggered a heart attack under controlled conditions to save a patient from imminent death. For the first time in Andhra Pradesh, a new procedure called ‘Septal Ablation’ was performed at Apollo Hospitals here on a 55-year-old patient suffering from hypertrophic obstructive cardiomyopathy.

A team led by Dr Rabin Chakraborty performed the procedure on the patient suffering from a thickening of the heart muscle. The team first identified the artery supplying blood to the thickened portion of the heart muscle and then injected ‘absolute alcohol’ to trigger a minor heart attack in order to close the hairline-type of artery. Absolute alcohol was sent up the artery using the procedure used to take an angiogram commonly used by interventional cardiologists to map the arteries of the heart.

The procedure was done on union minister Murosoli Maran, a few months ago by a team from UK and Germany. This is the first time that the procedure is being performed by Indian doctors in Andhra Pradesh.

Hypertrophic obstructive cardiomyopathy is a cardiac disorder, primarily afflicting the muscle of the heart leading to its abnormal thickness. This results in an asymmetry of the chambers of heart and the interventricular septum the partition wall between right and left ventricles-becoming thick.

Because of the abnormal thickness the septum obstructs the free flow of the blood from the main pumping chamber of the heart (left ventricle) thereby restricting the blood supply to the body, Dr Chakraborty said.

He said that patients with this condition had symptoms like shortness of breath, palpitation, chest pain, giddiness or even sudden collapse.

Nearly 50 per cent of the patients do not show any symptoms. Dr Chakraborty said it was a safe, simple and effective procedure to treat the ailment and involved carefully and controlled damage to the thick portion of the septum with the help of catheter, a balloon and absolute alcohol.

Explaining the procedure, he said a guide wire and a balloon was advanced into the artery supplying blood to the septum. After anchoring the balloon, absolute alcohol is injected through the balloon into the artery and thus the artery is selectively blocked. This results in the damaging of the thick muscle of the septum supplied by the artery. The entire procedure is performed under local anaesthesia and with close monitoring of the pressures, angiogram and ecocardiogram, he said.

This procedure has so far been performed on around seven patients in India with a success rate of over 90 per cent.

According to Dr P Seshagiri Rao, the new procedure offers significant improvement to the patient. Even after development of heart block, this can be efficiently managed by pacemaker implantation. The risk to life is very low by this extremely skilled procedure, he said. After the procedure, the obstructive pressure gradient dropped to 15 mm Hg from a level of 105 mm Hg in the patient. The condition of the patient improved and he was discharged from the hospital after a stay of 10 days. The cost for undergoing the treatment amounted to around Rs 1 lakh.

The procedure was performed by a team of doctors from Apollo Hospital here.