At the cutting edge of a medical breakthrough in the West of Ireland

The more observant of my readers will have noted that, by kind consent of the editor, the Return of Loftus at Large went missing this past couple of weeks, so I suppose one could say that the return of the column this week might correctly be referred to as The Second Coming.

Whether or which, it is with considerable relief that I can now reveal that my truancy was all in the interests of extending our medical knowledge and paving the way for a more simplified (if that is possible!) procedure to repair an aneurism of the aorta. Your columnist was at the cutting edge of a breakthrough in aneurism repair. 

At this point, it is appropriate to admit that up to May 14 of this year, I was blissfully unaware of what an aneurism was and equally ignorant of the consequences of said aneurism sitting on top of my aorta. I did have a hazy notion that I had an aorta but had no clue as to what function it performed. Sometimes, it is just as well not to know about these things. Leave it to the professionals, would be my approach.

And so it came about that I was introduced to Professor Sherif Sultan in the Galway Clinic. He is not a man who treats lightly with aneurisms. Not to put a tooth in it, he reckons that if the aneurism goes pop, that’s it. End of the road. Kaput. So he put me on his list for the introduction of a stent that would, in some way, fix the aneurism. I did not ask for the detail because it would not mean anything to a non-medical person such as myself. He called me in for a number of x-rays and ultrasounds and such like to establish that I was in shape to undergo this repair job on the aneurism.

I was giving the thumbs up myself, thinking I was as fit as a fiddle, but in stepped Dr Gordon Pate, Consultant Cardiologist, who spotted a number of deficiencies in the veins going to the heart and decided repairs had to be carried out before any job could be done on the aneurism. (Without referring to Dr Pate by name, I made brief mention of these stents in the veins in a column last May backend when I paid tribute to the excellence of our health service.) 

All of this, naturally, delayed the operation to repair the aneurism and it allowed the opportunity to hear further insights from Prof Sultan. He called to see me in my hospital bed and me having some family members visiting and announced that there was nothing really to worry about as there was a 98% success rate in aneurism repairs. Now everybody naturally latches on to the 98% and thinks that’s great. But when you are lying on the bed anticipating, perhaps dreading, what’s coming, the 2% becomes relevant. Still, there is nothing for it but to place your faith in the experts, accept that there is a far greater chance of being killed on our Irish roads and give a gung-ho thumbs up to the upcoming procedure.

I can understand if, my dear reader, you find the pace of this column to be somewhat turgid. The simple fact of the matter is that there are things in life that set their own pace. I had another chat with Professor Sultan or, being more precise, he had a chat with me. It was on the subject of alcohol consumption and it was even more unnerving than his 98% revelation re aneurism success rates. He is not a fan of alcohol. I detected that at the start of the conversation so I resorted to bending the truth in my responses. I have no doubt that he saw through me especially when I referred to units rather than pints. This is something that the medical profession would like the public, especially the drinking public, to engage with. Measure your drinking by units and your consumption will go down. We’ll all be better off. That’s another rant off my chest….. perhaps less pressure on the aneurism, which is now repaired.

So, finally, we come to my role in this ground-breaking piece of medical history. It was a minor role but quite important. I had no speaking lines, and no walk-on role. I was not even to be seen as an extra. In fact, I was wheeled in and was out for the count, so I’ll let Professor Sultan, as detailed in his LinkedIn page, and speaking for his incredible team of essential performers, take up the story: 

“We are proud to announce the successful launch of the GORE TBE Endo-Thoracic Graft at Galway Clinic, part of the Blackrock Health Group. The first-of-its-kind procedure using this FDA-approved device was performed by the esteemed Master of Endovascular Surgery, Professor Sherif Sultan, alongside his highly skilled vascular team.

“The GORE TBE Endo-Thoracic Graft is specifically designed for simplified, minimally invasive Zone 2 Thoracic Endovascular Aortic Repair (TEVAR) procedures. This innovative device aims to maximise clinical outcomes while minimising the potential risks and complexities associated with open debranching or revascularisation surgeries.” 

Commenting on the ground-breaking procedure, Professor Sultan stated: "The GORE TBE device has demonstrated exceptional safety and efficacy, particularly in patients requiring TEVAR without an adequate landing zone.

“This device offers an ideal solution for lesions in Zone 2, ensuring continued antegrade perfusion of the left subclavian artery (LSA) without necessitating endograft modifications, parallel stenting techniques, or additional open revascularisation."

“One of the significant advantages of the GORE TBE Endo-Thoracic Graft is its user-friendly design, which does not require a learning curve. Our experience in elective settings allowed us to develop immediate comfort with the device, thereby improving our success rates in more urgent settings," added Professor Sultan.

"This landmark procedure at Galway Clinic underscores the clinic's commitment to leveraging advanced medical technologies to enhance patient care. The introduction of the GORE TBE Endo-Thoracic Graft represents a significant advancement in the treatment of complex aortic conditions, providing a new and effective option for patients in need of Zone 2 aortic repair."

You will understand why I left it to Professor Sultan to speak of these ground-breaking developments. I can grasp what has been achieved but can’t take in the detail. We don’t need to understand the detail. We have people to do that for us. It goes without saying that I appreciate the wonderful people who work in our health service and who produce such incredible results.

When I came around after the anaesthetic, I found myself in Room 1 in the Intensive Care Unit (ICU) where I was wonderfully, caringly and professionally looked after by the most exquisite team of nurses. In the team were Irish, Indian, African, female and male nurses. There may have been other nationalities. I dislike having to make reference to nationality but unfortunately in today’s Ireland of bigots and racists, it is necessary to do so.

I just wonder what kind of a medical service we would have in this country if we were to ask all those people of colour, other than white, or nationality, other than Irish, to return to their countries of origin and leave us to our own devices.

For sure, we would have a hell of a poor medical service. We would have a hell of a poor country. It is time the bigots and racists were called out for what they are. It is past time we properly recognised and appreciated the magnificent contribution being made daily by our immigrants.

Thought for the day

Nuair a bhionn an fíon istigh, bionn an chiall amuigh