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Against the odds, Princeton Baptist cardiologist saves patient's life

by Lauren Dubinsky, Senior Reporter | February 10, 2016
Cardiology CT Medical Devices X-Ray
Dr. Mustafa Ahmed (right)
during the procedure
What started as a seemingly impossible case, turned into a medical breakthrough that saved the life of a patient with a massive heart aneurysm. Dr. Mustafa Ahmed, medical director of the Structural Heart Program at Princeton, undertook a more than 20-hour procedure to treat Jason Philpot’s aneurysm, despite the fact that no such case has been attempted before.

“Every option was on the table for him — whether he wanted to just watch and see what happened, which he didn’t want to do, or whether he wanted to have a very high-risk procedure. But of course, we take steps to minimize [risk] as much as possible,” Ahmed told HCB News.

Philpot, a 39-year-old father of two who lives in Georgia, had a series of heart issues dating back to early 2012. Then those issues took an unrelenting turn for the worse in spring 2015 when a small heart aneurysm grew into what Ahmed described as "one of the largest aneurysms" he had ever heard of.

It was “visibly protruding through his chest wall” and “pulsating strongly through his shirt." In addition to that, Philpot had another aneurysm that was connected to his heart, which was leaking a large amount of blood into his heart.

Even though it was unlike anything that Ahmed was able to find in medical literature and it seemed that his patient’s life expectancy was only a few weeks, Philpot’s two-year-old son, Grey, was the one who convinced Ahmed that it was a procedure worth attempting.

Before the procedure, Ahmed consulted Dr. Mark Law, pediatric cardiologist at Children’s of Alabama, to plan a course of action. “Between us we probably have the most experience in the state doing this kind of the stuff,” said Ahmed.

The more than 20-hour surgery was split into two parts with the first procedure occurring in July 2015 and the second in August 2015. Ahmed and his team reached the aneurysm by going through the blood vessels and then through the heart chambers and inserting catheters.

Through those catheters, they were able to place multiple coils into the aneurysm, which would take up space within it and then cause it to eventually clot and prevent more blood from flowing into it and expanding. They then placed a vascular plug into the aneurysm and fistula, between the aorta and the left ventricle, which stopped the leaking of blood.

Image guidance was an integral part of the procedure. Before the procedure itself, the team had to perform multiple different scans with a 3-D transesophageal echocardiogram and a CT. During the procedure, they used fluoroscopy with angiography.

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