Fortis Malar Hospital recently employed Extra Corporeal Membrane Oxygenation (ECMO) technology to save the life of a 56 year old man who suffered a massive heart attack. Though gaining ground in the West, this technology is relatively new to India. The team of Fortis Malar doctors led by Dr. K.R Balakrishnan - Director of cardiac sciences; Dr. R. Ravi Kumar – Senior Consultant- Interventional Cardiology; Dr. Madan Mohan – Interventional Cardiologist Dr. Suresh Rao K.G. – Head-Cardiac Critical Care & Cardiac Anesthesia and Dr. Nandkishore Kapadia – Senior Consultant-Cardiac Surgery; worked together to save his life.
The doctors encountered the 56-year-old gentleman who was in a state of circulatory collapse after suffering a massive heart attack. Soon after admission he had a cardiac arrest which needed CPR and external cardiac massage. Because of the possibility of near certain death in this scenario, without more aggressive treatment, Doctors decided to support his circulation using a small portable sophisticated artificial heart pump called Extra Corporeal Membrane Oxygenation (ECMO).
This pump was made available in an assembled condition at Fortis Malar Hospital by the cardiac surgical team under Dr. K. R. Balakrishnan & Dr. Nandkishore Kapadia. In an attempt to improve heart circulation, the patient subsequently underwent an angioplasty in the cath lab by Dr. Ravi Kumar and Dr Madan Mohan , Cardiologists. The whole process was supervised under the expert guidance of Dr. Suresh Rao K.G., Chief Critical Care, who was also instrumental in taking care of the patient in the Intensive Care Unit.. The patient responded well to the treatment.
Heart is a pump made of smooth muscle whose constant function is necessary to keep all organs of body healthy. Massive heart attack (large acute myocardial infarction) has a high possibility of death even if patient reaches the hospital alive. Cardiac Pump failure (cardiogenic shock) can occur at anytime after heart attack and this has a mortality of over 90%. Emergency angioplasty (PTCA) may not work in cardiogenic shock because, many times the heart muscle does not recover fast enough for all organs to remain healthy.
Commenting on the procedure, Chief Cardiac Surgeon – Dr. K. R. Balakrishnan said, “ECMO Technologies Have Great Potential To Save Lives In And Out Of Hospital Especially In Cardiac Arrest Situations Following Heart Attacks. I Foresee Great Potential For This Technology In The Near Future In Countries Like India With Extremely High Incidence Of Untreated Coronary Disease”.
Using powerful new technologies currently available like “artificial heart pump (ECMO)”, the patient’s circulation can be supported for as long as upto one month. This gives much needed time for vital organs like brain, kidney, liver and heart to recover and function normally. ECMO (Extra Corporeal Membrane Oxygenation) can also be used in patients with badly damaged lungs as in H1N1 influenza and infants with meconium aspiration. This highly effective technology has great potential to save a lot of lives in emergencies and has been proved to be of great benefit in western countries like France and USA. This equipment can take over the function of heart and lung. Hence it is useful when the heart fails as in heart attack or when the lung fails as in case of H1N1 infection.