LADY ABLE TO EAT after rare major vascular and thoracic surgery

Ludhiana, March 26, 2013: Kamaljeet Kaur (52), housewife, was in a very disabling condition. She was unable to eat anything .the reason was that she had an abnormal origin of the right subclavian artery (the artery of the hand). This was travelling behind the food pipe (esophagus) causing obstruction so that the patient could not eat. She was rapidly losing weight. She was referred to Dr. Harinder Singh Bedi – Head of Cardio Vascular Endovascular and Thoracic Surgery at the Christian Medical College &Hospital, Ludhiana.

Dr. Bedi explained that the condition is a rare one called dysphagia lusoria – a Latin word meaning that – nature is playing a horrible jest (joke) on the patient. Dr. Bedi said that indeed this was a serious condition as the patient was in imminent danger of malnutrition as no food was going into the stomach.

Additionally a new anomaly was that the course of the abnormal artery was unusual as instead of passing in the neck as reported in the literature it was coursing in the chest itself. This added to the complexity of the problem as the right chest of the patient would also have to be entered. Dr. Bedi had posted the case on the internet to experts all over the world and also did an internet medical search of the disease entity. There is no reported case of this unusual variant of the disease.

A marathon surgery was done. First the artery was exposed in the neck. Then it was disconnected from its abnormal origin in the chest .Dr. Bedi told that this cured the obstruction. However, now the problem was of finding a new source of flow to the hand. The right hand would otherwise turn black. Also as a major brain artery (the vertebral artery) was originating from the abnormal artery. If flow to this was not re-established the patient could suffer a brain stroke. So the disconnected artery was now re-connected to the carotid artery in the neck. This established a normal circulation.

This surgery needs a surgeon trained in both cardio vascular and thoracic surgery .Dr. Bedi is a pioneer in both fields and in fact has trained in both specialities at the St Vincents Hospital in Sydney. However this was a very challenging case because of the imminent risk of hand gangrene and stroke while treating the obstruction. The surgery went well and MrsKamaljeet is now able to eat .The other members of the Heart team are Dr A Joseph, Dr. Anish Verghese ,Dr. Sheetal Garg, Dr. Melchi,  Dr. Amol , Dr. Sheriff and Dr. A Puliyeli.

Dr Abraham G Thomas – Director of CMC & H – said that the CMC was committed to bringing the latest technology to Punjab so that the people of this area were given the best possible therapy.