Kauvery Hospital successfully treats a woman with a life threatening undetectable auto-immune blood clotting disorder

Antiphospholipid syndrome is a disorder characterized by an increased tendency to form abnormal blood clots (thromboses) that can block blood vessels.

Chennai, 16 th November 2022: Kauvery Hospital Chennai, a unit of Kauvery Group of Hospitals, a leading multispecialty healthcare chain in Tamil Nadu, today announced the successful treatment of a 33-year-old woman with a rare autoimmune blood clotting disorder called APLA(Antiphospholipid) syndrome, in which the immune system creates antibodies that attack tissues in the body. These antibodies further cause blood clots to form in arteries and veins.

The woman initially approached with complaints of a blood clot in the leg. However, only after a thorough examination was she diagnosed with APLA syndrome. The medical experts found that the condition had gone undetected for over 4 years and blood clots had spread to different parts of the body. She was further diagnosed with Pulmonary Embolism (a condition in which one or more arteries in the lungs become blocked by a blood clot) and Deep vein thrombosis- DVT( a condition which occurs when a blood clot (thrombus) forms in one or more of the deep veins in the body, usually in the legs) along with Inferior Vena Caval (IVC) Thrombosis as multiple blood clots were found to be completely blocking the blood vessels which go from the legs to the lungs and heart.

She was immediately administered with blood thinner medications where further blood clotting was prevented as there was already a significant number of clots present in the lungs. The medication, however, was not completely effective in dissolving the existing clots. The delayed diagnosis further aggravated her condition, as the blood clot blocked a significant portion(almost 70 percent) of the lung over the past few years which reduced the amount of area in which the blood goes to the lungs additionally cutting the flow of blood, making it difficult for the heart to pump the blood. Her condition progressed to organized clots, where her clots merged into the blood vessel and further made it narrow.

The medical experts who studied the condition thoroughly decided to perform an Endarterectomy (surgical removal of part of the inner lining of an artery, together with any obstructive deposits, most often carried out on the carotid artery or vessels supplying the legs) as they concluded that the condition could not be resolved by just removing of the blood clots but by stripping the covering of the narrow blood vessels as well.

A complex surgery was initiated under anesthesia where the woman's heart was arrested completely and the blood was pumped through an artificial bioset. She was further placed in a deep cooling condition, where the temperature was maintained at 20 degrees such that the brain function is slow and the flow of oxygen is maintained due to the risk of death involved in the condition. The surgery was performed in cycles of 20 minutes where in every alternate 20 minutes, her blood flow would be cut and each side of the blood vessel would be stripped. After each cycle, the blood flow circulation would be restarted to protect the brain. The surgery was successfully completed after 5-6 hours, where the woman recovered successfully.

Speaking on the condition, Dr. Aravindan Selvaraj, Co-Founder & Executive Director, Kauvery hospital Chennai, "APLA syndrome is a sporadic condition that is life-threatening and can go undetected for a long time. Anyone having blood clot issues should get it consulted without delay, around 3-5 percent of people develop this condition. Medication alone does not help, as there are multiple tests that track the progress of this condition. Clots in the lungs and heart, make it difficult for the heart to pump blood, which is required to carry oxygen all over the body, if this flow is disrupted, the heart and eventually the entire body will fail. For people with heart pumping problems related to a blood clot, the chance of surviving even 5 years is less than 10 percent. These figures are much worse than cancer but are hardly recognized by people.   In this particular instance, the woman's condition had become so serious that her right side of the heart was measuring a pressure of 134 compared to the left side of the heart which was measuring 120. While in an ideal scenario, the right side of the heart of a normal individual measures much lesser pressure than the left as it is not naturally designed to handle so much pressure. Her condition aggravated due to this, where her heart and liver started failing and her kidneys started to swell up and not function properly. This endangered her life. Recovery is hardly possible at such stages due to the significant damage on vital organs like the liver and kidneys. I encourage people to keep an eye on such rare and easily undetectable conditions, which cannot be diagnosed so easily. Few studies have however shown that multiple fetal losses and unsuccessful pregnancies are one of the symptoms to diagnose this. Here as well, the lady, unfortunately, could not bear a child due to the presence of this condition.

However, we were able to manage to save her life from this life-threatening condition, and for that, I would like to congratulate Dr. XXXX and his team of medical experts for their brave efforts.

The woman currently successfully recovered from her condition and discharged will have to continue with anti- clot medication for the rest of her life, as the surgery only mitigates the primary problem of the condition which is removing the clot and not preventing the further development of it.


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