A simple heart screening revealed Mahmoud’s tumour
At 55, Mahmoud had never felt fitter. The orthodontist from northwest London enjoyed daily exercise classes and a range of sports. It was only when a relative was diagnosed with cardiovascular disease that his wife suggested he arrange a routine heart health check-up.
He expected to walk away with a clean bill of health, but instead the scans revealed a benign tumour that was placing him at risk of stroke.
Thankfully it was caught in time to be removed through a minimally invasive endoscopic procedure at HCA Healthcare UK’s The Harley Street Clinic by Mr Toufan Bahrami, one of few surgeons in the UK who can perform this cutting-edge surgery.
Twelve days later Mahmoud was back at work. Just six weeks later, he was skiing. Today, he urges everyone in middle age to seek regular heart health checks, even if they’re suffering no symptoms.
Swift referral
Mahmoud’s cardiologist immediately referred him to Mr Bahrami at The Harley Street Clinic. The esteemed cardiothoracic surgeon has carried out more than 4,000 heart operations and specialises in endoscopic heart surgery.
Mahmoud met him just five days after his diagnosis. The surgeon explained surgery was vital – small parts of the tumour or clots could break away and travel into the bloodstream, an embolism, potentially moving to the brain and causing stroke.
“This could have happened at any time,” says Mahmoud. “Mr Bahrami could only guess how long the tumour had been there, perhaps five or ten years. I try to keep fit and yet this had developed completely out of my control.”
Mr Bahrami reassured Mahmoud the tumour could be removed in a minimally invasive endoscopic procedure via a small, one-inch chest incision, avoiding open heart surgery. This innovative procedure, guided by imaging from a 3D camera inserted on a thin tube through a 5mm incision, is performed by only a few surgeons in Europe.
The only other small incisions needed would be for a 5mm post-surgery drain and a 2cm incision at the level of groin to connect to the heart-lung machine during the surgery itself.
“I felt comfortable about Mr Bahrami’s expertise,” says Mahmoud. “He explained that, although this was a complex procedure, it could be done under his care with low risk.”
Complex surgery, minimal impact
The procedure took place at the end of January following rigorous testing. This included a 3D CT scan of the chest, and an internal echocardiogram performed via the oesophagus under brief general anesthetic to locate the tumour, its size and precise localisation. “Mr Bahrami and his team were very thorough,” says Mahmoud. “There was a lot of preparation to ensure my safety.”
The surgery itself took five hours, but initially there was a two-hour wait while Mahmoud was under general anaesthetic because his blood glucose level rose sharply in response to stress. “They caught it and made sure everything was under control,” says Mahmoud.
Another challenge was that the tumour was located close to vital parts of the heart’s conduction, or electrical, system. The team had to make critical adjustments, demanding even greater surgical skill and more time for repair afterwards. “Mr Bahrami had to be extra careful not to damage that electrical apparatus,” explains Mahmoud.
Fast recovery
Mahmoud remained in hospital for a week. “Mr Bahrami was in contact every single day,” he says, “and the nursing team was absolutely wonderful. I had some discomfort from the incisions, but nothing major. My breathing was also a little more laboured, and I became tired with minimal movement.”
But very swiftly Mahmoud began to improve and was soon able to exercise. “One week later I started to lift light weights. My breathlessness got considerably better, and I began driving again. After three weeks, following advice from Mr Bahrami, I joined a gym. I would walk on treadmills and lift light weights. After a month I felt fairly normal.”
Six weeks after the procedure Mahmoud went skiing with his family, after seeking Mr Bahrami’s advice. He smiles: “I skied five days in a row. I became tired sooner, but I could easily do a whole day with proper rests.
“The procedure had no more than three weeks impact on my life. Open heart surgery would have impacted me for three or four months at least.”
Mr Bahrami was in touch on a weekly basis for a month. Less than three months on, Mahmoud says he won’t need to see him again for around a year.
Get tested
Regular heart check-ups are now on Mahmoud’s to-do list. Mr Bahrami explained his tumour would probably have started to make itself known within a couple of years with symptoms such as fatigue, which Mahmoud could easily have shrugged off as aging, or more serious consequences such as stroke.
As well as the dangers posed by a tumour, the later it is found, the more complex its removal and therefore, recovery.
“Mr Bahrami said we should all get a heart screen as we approach our late forties and fifties, especially if there is some history of cardiovascular disease,” says Mahmoud. “Many people don’t, and present to him very late.”
He adds: “If a problem is treated early the chances of recovery are better and a patient is motivated to get healthier at a younger age.”
This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.