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November 14, 2000

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Maran's condition improves

Shobha Warrier in Madras

The condition of Murasoli Maran vastly improved on Tuesday, with him breathing without the support of artificial ventilators.

A panel of experts reviewed Maran's condition Monday afternoon and decided to discontinue ventilatory support.

The improvement began after he was given a risky but revolutionary septal alcohol ablation on November 8 and 10. After reviewing his health on Saturday, Dr Horst Khun, an interventional cardiologist from Germany, decided to give him septal ablation a second time.

At 9.30 am on November 7, Maran went into severe pulmonary odema and was put on an artificial ventilator. He was critical and as his condition steadily deteriorated. The doctors had two options: perform surgical myotomy or give alcohol ablation.

After a series of discussions with specialists and family members, they decided to give him alcohol ablation.

Maran was given two injections of 1/2 cc of absolute alcohol to produce a controlled infraction of the intra-ventricular septum, thus relieving the dynamic obstruction of the outflow.

Dr Ulrich Sigwart, chief of invasive cardiology, Royal Brompton Hospital, London, said alcohol ablation was the best for Maran. He felt that it was generally done as an elective on patients who walk in and who are not in acute distress. As there was no option, the hospital authorities decided to give alcohol ablation to the minister, who was sinking and whose heart muscles were refusing to pump blood. Luckily, Maran responded well to the treatment.

On Friday, Dr Horst Kuhn, who flew in from Germany, informed the press that blood flow from Maran's heart improved vastly after the alcohol ablation treatment and the edema of his lung also reduced.

Dr Kuhn observed that patients who underwent septal ablation while critical constituted only three per cent elsewhere in the world. He also commended the performance of doctors at Apollo Hospital.

Dr Kuhn said obstructive cardiomyopathy was a genetic problem and often the patient would not know about it in advance due to lack of symptoms.

Dr Kuhn, who was supposed to leave India on Saturday, stayed back to review Maran's condition. In view of his persisting lung congestion, it was decided by Dr Kuhn and the panel of doctors to give him septal ablation for the second time. Maran responded well to the treatment.

When the doctors reviewed his condition on Tuesday afternoon, his vital parameters like blood pressure, pulse and urine output were normal. But Maran is still in the intensive care unit and his pulmonary condition after discontinuing the ventilatory support is being closely monitored.

The hospital has included a consultant pulmonologist in the panel.

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