GCC national patient with rare heart condition receives life-saving surgery at Cleveland Clinic Abu Dhabi

Cleveland Clinic Abu Dhabi, part of the M42 group, successfully performed life-saving open chest surgery to treat a 31-year-old patient, suffering from Chronic Thromboembolic Pulmonary Hypertension (CTEPH).

This life-threatening condition is caused by high pressure within the pulmonary artery which affects the vital flow of blood from the heart to the lungs. This rare disease affects approximately 3 to 30 individuals per million and has a high mortality rate. Approximately 0.4% to 4.8% of patients diagnosed with acute pulmonary embolism will develop CTEPH. 

Abdullah Al Shammari, suffered from the rare disease for five years and his severe symptoms included multiple blood clots and coughing up blood. He was admitted to Cleveland Clinic Abu Dhabi when his coughing intensified into vomiting blood which led to heart failure. 

To tackle Abdullah’s complex case, the multidisciplinary team at Cleveland Clinic Abu Dhabi devised a comprehensive approach for diagnosis and treatment planning. It has achieved a remarkable 100% success rate, ensuring excellent survival outcomes without any instances of mortality or significant morbidity.

Dr. Usman Ahmad, Department Chair of Thoracic Surgery at the Heart, Vascular and Thoracic Institute described the condition as potentially life-threatening if left untreated. "Upon our initial assessment, we recommended several tests to pinpoint the root cause of Abdullah's condition. Through this process, we found evidence of CTEPH. Abdullah faced abnormal pressure in his heart, coupled with extensive clotting in the blood vessels beneath it. These clots had migrated to his lungs, causing significant breathing difficulties and escalating heart pressure, ultimately leading to heart failure,” said Dr. Ahmad.

Explaining the complexity of anesthesia in such complex cases, Dr. Arun Kumar, Staff Physician, Cardiothoracic Anesthesia, Anesthesiology Institute said, "During the procedure, we had to fully open the chest and connect it to a heart-lung bypass machine to do a deep hypothermic circulatory arrest. This involved lowering Abdullah’s body temperature to 18°C to temporarily halt bodily functions. During this period, we carefully assess the lung blood vessels, meticulously removing scar tissue to restore functionality. Subsequently, blood circulation is resumed via the machine, gradually warming the body and reactivating the heart and lungs, enabling normal function to resume."

Al Shammari said, “I felt suffocated, my illness left me feeling distracted and confused. I couldn't walk, talk, or do anything. I pretended to be strong on the outside but was broken inside. My suffering began with intense coughing up blood. One day, it worsened, leading to terrifying amounts of vomiting blood.”

Removing blood clots or scarring inside the lung is a technically demanding procedure. It requires meticulous anesthesia to halt heart function and blood flow throughout the body during the eight-hour surgery. Abdullah was cared for by a team of surgeons, pulmonologists, cardiologists, interventional cardiologists, and interventional radiologists at Cleveland Clinic Abu Dhabi. 

Explaining the complexity of anesthesia in such complex cases, Dr. Arun Kumar, said, "In complex cases such as CTEPH, the stakes are high. As an anesthesiologist, my focus is on preventing dangerous drops in blood pressure. Meticulous attention to detail is required in planning and execution and care. It's about safeguarding every patient's well-being with every decision we make.

"When I regained consciousness after ten hours in the recovery room, I was in pain, but soon I began to feel much better, and my condition improved significantly. I could breathe again, the suffocation vanished, and it felt like I had been given a new lease of life. The doctor even told me that I was born again," said Al Shammari, who now leads a happy and healthy life with the support of lifelong medication.

Al Shammari’s journey to restore health is a reaffirmation of Cleveland Clinic Abu Dhabi’s personalized, multidisciplinary approach to care, enhanced with the use of cutting-edge technologies.