A novel procedure to effectively treat severe Asthma cases

Doctors at Aster CMI Hospital have successfully performed Karnataka’s first Bronchial Thermoplasty (BT) on a 68-year-old, Mr. B Arogyanathan who has been suffering from severe Asthma for the past 20 years. Hailing from Jalahalli Mr. Arogyanathan has been trying all possible medications for asthma with no relief. He is the first gentleman to have benefited from this procedure in the state of Karnataka.

Bronchial Thermoplasty is a novel and promising treatment strategy for those with severe asthma who have repeated wheezing attacks despite being on maximum outpatient medications. Repeated asthma exacerbations lead to incremental loss of lung functions and worsening quality of life of these patients eventually leading to increased hospital admissions and sometimes progressing to a chronic form of lung disease requiring dependence on oxygen. In earlier days, these patients would gradually deteriorate without an apt intervention and become homebound or are breathless even during their daily activities.

Speaking on the procedure, Dr. Sunil Kumar K, Lead and Sr Consultant – Interventional Pulmonology, Sleep Medicine & Transplant Physician, Aster CMI Hospital said, “At our airway disease clinic at Aster CMI we phenotype all the patients with asthma and depending on which subset they fall into they are offered targeted medications or BT. BT is a bronchoscopic procedure done with the patient comfortably sedated and under anesthesia. The procedure involves 3 treatment sessions at 3-week intervals. In this procedure using a special catheter heat is applied to the airways involving the right lower lobe, left upper lobe and both upper lobes in different sessions. The intention is to reduce the thickness of the muscle mass around the breathing tubes so that they are less squeezed. The muscles usually twine around the breathing tubes like a rubber band, unyielding to regular medications and thereby choking the tubes. Data from three large randomized trials till date have shown in favor of bronchial thermoplasty in patients with severe asthma with a particular phenotype. The outcomes are phenomenon and propitious showing improvement in quality of life, reduces the number of exacerbations would otherwise need treatment at the hospital. Also the procedure has shown to improve the lung capacity and reduce airway twitchiness.”

Dr. Srivatsa Lokeshwaran, Consultant – Interventional Pulmonology, & Transplant Physician, Aster CMI Hospital, said “Asthma is a substantial global health problem with increasing prevalence rates in many countries.  It is one of the leading causes of morbidity and mortality in rural India. Asthma is a controllable chronic disease process just like blood pressure or diabetes and if kept under constant check and necessary measures are taken at the right moment it can prevent such scenarios where the patient progresses to poor quality of life. Roughly around 10 percent of the asthmatics fall in the category called poorly controlled asthma which does not respond to the regular medication and it necessitates special investigations to understand which sub category they fall into. Only after that and preliminary tests can we decide if the patient is a suitable candidate who would benefit from the therapy. The procedure is a safe daycare procedure without significant adverse effects.”

Thanking the doctors, Arogyanathan said, “I have been experiencing bronchitis for 20 years. After years-long of medical treatment, my condition did not show any improvement. Then I took treatment here at Aster CMI and doctors suggested I undergo bronchial thermoplasty. After the first treatment, I was feeling better, and my condition improved a bit. Then, I underwent the treatment for the second time. After that, my breathing has improved, and I have been experiencing good health.”