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
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.