Air rescue & surgery in nick of time - Ludhiana-Mumbai flight with life support blinking

Mumbai, June 26: A 70-year-old woman, on life support for a week after a rare and lethal rupture in the heart hundreds of miles from home, was flown back through five hours of turbulent weather for a critical surgery that has saved her life.

The dramatic “rescue” of Mumbai resident Satya Devi Gandhi, which mirrored Hollywood rather than the Indian reality, was achieved through a feat of co-ordination between heart surgeons, paramedics, an air ambulance service and hospitals across two cities.

It also helped to have India’s richest man, Mukesh Ambani, putting in a word to line up the best of medical services: Devi is the mother of one of his employees.

Devi was visiting her relatives in Ludhiana when she suffered two massive heart attacks on June 14 and June 15. The strokes ruptured her ventricular septum, the partition between the heart’s two lower chambers that prevents mixing of pure and impure blood.

“(Only) about 1 per cent of heart attack victims suffer this. It requires very difficult surgery and most patients die. Besides being old, she had high blood pressure, diabetes and asthma,” said Dr Vijay D’Silva, the Mumbai-based intensive-care specialist who accompanied Devi from Ludhiana to Mumbai.

In Ludhiana, after putting Devi on life support for a week, the doctors had given up. Her son V.K. Gandhi, senior Reliance vice-president, consulted top cardiologists in Delhi and Chandigarh before knocking at the doors of Dr Ramakant Panda, the Prime Minister’s heart surgeon.

“A rupture in the ventricular septum… is considered rarest of the rare. Even top cardiologists do not get five such cases in their lifetime,” said Dr Panda, MD and vice-chairman of the Asian Heart Institute (AHI), Mumbai.

“The rupture leads to a mixing of the oxygenated (purified) blood from the lungs with deoxygenated blood. This results in circulation of deoxygenated, impure blood across the body which can prove fatal,” said Dr D’Silva, director, medical affairs and critical care, the AHI.

It was decided to shift Devi from Ludhiana to the AHI in a chartered air ambulance.

“Such critical patients are usually not transferred since they are on life support systems which are battery-operated with a capacity of only two hours. The Ludhiana-Mumbai flight takes five hours,” Dr D’Silva said.

The hospital contacted the company that makes the Intra Aortic Balloon Pump (IABP), a circulatory life-support system, to arrange for two expensive spare batteries and a technician to accompany Dr D’Silva to Ludhiana.

“We left Mumbai on June 21 in the air ambulance with all the necessary equipment. We landed in Ludhiana at 11am and drove 18km to the hospital. I immediately connected the patient to the IABP and we left for the airport around 12.15pm. We took off around 1pm,” Dr D’Silva said.

With one in-built IABP cell and two spare ones, Dr D’Silva and his team had their hearts in their mouths as they started the long flight back to Mumbai through monsoon turbulence.

“Soon her condition started deteriorating. The IBP battery, which lasts just two hours, had to be changed twice mid-air. It was difficult, especially since her condition was serious and the weather pretty bad,” the doctor recalled. “Things got difficult when we had to change the battery amid air turbulence. But pilot Bharat Yadav negotiated the weather ably and landed at 6pm.”

Every minute of the half-hour drive to the AHI counted.

“It was rush-hour traffic. The last battery had begun blinking. I called the hospital and asked them to place their life-support system at the gate of the emergency. As we crossed the hospital gate, the battery was on its last few seconds. As we fitted her to the last cable of the hospital life-support machine, the battery went blank,” Dr D’Silva said.

Dr Panda and his team operated on Devi on June 22. “She had bypass surgery for blockages and a surgery to repair the ventricular rupture. She was off life support by June 24 and is now up and about, eating well and talking,” Dr Panda said.

“We hope to take her off intensive care by June 29. What we achieved is unprecedented in India.”

V.K. Gandhi said: “For us, Dr Panda and Dr D’Silva are like God’s angels.”

For the millions who can’t match Gandhi’s financial might — his bill so far is Rs 15 lakh — such fairytale endings will remain in the realm of fantasy.