Chennai, 20th June
2025 : In a remarkable feat of medical precision, Kauvery Hospital Alwarpet has
saved the life of a 62-year-old man through an advanced cardiac procedure
involving ECMO-CPR (Extracorporeal Cardiopulmonary Resuscitation) a rare,
complex intervention reserved for the most critical cases of cardiac arrest.
The patient, who was rushed
to the Emergency Department with a major anterior wall myocardial infarction,
was found to be in cardiogenic shock (when the heart struggles to pump blood to
the body) with dangerously low blood pressure and reduced perfusion to vital
organs. As he was being shifted to the Cath Lab for an emergency angioplasty,
he went into cardiorespiratory arrest (heart and lung functions stopped).
Despite high-quality conventional CPR, there was no return of spontaneous
circulation placing him in refractory cardiac arrest, a condition where survival
is rare without advanced support.
Recognizing the gravity of
the situation, the team comprising Dr R Anantharaman and Dr S Srikumar swiftly
initiated ECMO-CPR, wherein blood was drained via cannulation from the femoral
vein(a major deep vein in the leg that runs alongside the femoral artery),
routed through an artificial membrane (oxygenator) that removed carbon dioxide
and added oxygen, and then pumped back into the body through femoral artery.
This external circulatory support maintained oxygenation and other organ
perfusion, allowing the heart and lungs to rest while the underlying cause,
blocked coronary arteries, could be treated.
Senior Interventional
Cardiologist Dr. R. Anantharaman explained, “This patient had zero cardiac
output while being wheeled into the Cath Lab. ECMO-CPR provided the precious
time we needed, with oxygenated blood circulating to the rest of the body
safely, we were able to perform a high-risk multivessel coronary angioplasty
and stenting despite the heart being non-functional. Slowly, cardiac
contractility returned.”
Following the procedure, the
patient was shifted to the Coronary Care Unit (CCU) on ECMO and later
transitioned to Intra-Aortic Balloon Pump (IABP) support. However, recovery was
not linear. He developed a VT (ventricular tachycardia) storm, a
life-threatening arrhythmia which was initially managed with medications and a
stellate ganglion block, a nerve-numbing injection administered in the neck. As
the VT episodes persisted, Electrophysiology team lead by Dr Deep Chandh Raja
intervened with a radiofrequency ablation, successfully eliminating the
arrhythmic focus. With a now stable rhythm, his heart function recovered to
over 50% ejection fraction, and he was gradually weaned off all mechanical
supports, mobilized and discharged home.
Dr.S.Srikumar, Senior
Consultant Interventional Cardiologist observed “ The chances of a patient
having sudden cardiac arrest following an acute myocardial infarction surviving
to discharge is less than 15% with conventional CPR techniques, but the odds of
his survival and going back home is doubled to around 30% with the timely
initiation of ECMO-CPR.”
Dr. Aravindan Selvaraj,
Co-Founder and Executive Director, Kauvery Group of Hospitals, said,
“Performing a high-risk procedure like ECMO-CPR requires not just timely
decision-making, but also a well-trained multidisciplinary team, advanced
cardiac infrastructure, 24×7 Cath Lab access, and round-the-clock ICU support.
Our ability to seamlessly bring together interventional cardiologists,
electrophysiologists, intensivists, anesthesiologists, cardiac surgeons,
perfusionists, and critical care nurses is what made this outcome possible”
The patient was discharged
after a 21-day hospital stay, fully mobile, neurologically intact, and
emotionally overwhelmed with gratitude. This success story also shows the need
for greater awareness about ECMO-CPR, a modality that can improve survival in
up to 30–50% of patients with refractory cardiac arrest, when executed in time
and in a center equipped with the right expertise and infrastructure.