Wednesday 30 December 2015

Surgeons perform life-saving procedures on Moroccan teen with 'ticking time bomb' on face


An 18-year-old Moroccan man with a so-called “ticking time bomb” on his face will return home this week after doctors performed seven life-saving surgeries on him in New York. Zoubir Lahdodi was born with venous malformation, which causes blood vessels to abnormally form and dilate. Up until the surgery, necessary tasks like eating, sleeping, breathing and talking were becoming increasing difficult for Lahdodi.

About eight months ago a member of Lahdodi’s family emailed Dr. Milton Waner, director of Vascular Birthmarks Institute at Lenox Hill Hospital in New York, with a plea for help. Waner, who has treated patients with venous malformation before but never a case as severe as Lahdodi’s, immediately began making travel arrangements to bring Lahdodi to New York. Through various charities and Lenox Hill Hospital, Waner arranged for Lahdodi and his mother to travel the 3,600 miles from Casablanca to New York City, where they stayed at the Ronald McDonald House. The hospital also covered his hospital stay and the cost of his procedures.
“It became immediately apparent to me that Zoubir had a very serious condition,” Waner told FoxNews.com. “It had advanced very severely, and it was endangering his life.”
Waner explained venous malformation is a genetic abnormality which occurs in utero, but it is not an inherited condition. Loudid’s case is considered a mosaic abnormality, in which it involves only portions of the body.
“These are genetic abnormalities, and we’ve identified some of the genes associated with venous malformation but not all of them,” Waner said. “It’s clearly a genetic abnormality, but the abnormal gene was not throughout his entire body— only in a certain region of the face.”
Waner said as patients with venous malformation age, the veins continue to dilate and their condition worsens. Quality of life is also severely impacted, as a simple bump or bruise on the affected area of the body could be deadly.
“It’s relentless,” Waner said. “At some stage, one or more of these vessels will rupture. Usually it’s associated with minor trauma or it can be spontaneous, and this will lead to a huge, massive hemorrhage and these hemorrhages can be fatal. In addition to this problem, Zoubir’s venous malformation was encroaching on his airway so at some point it would affect his ability to breathe.” 
One challenge Waner and his team faced was the delicacy of the procedures. Accidentally disrupting one of the dilated vessels would cause it to rupture, leading to uncontrollable bleeding. Waner said that under these circumstances patients could possibly lose up to a liter of blood in only 60 seconds.
“We had a few very difficult moments in the operating room,” Waner said. “A few very dangerous moments, but we came through OK. He’s now in a position where he is no longer in danger, and this is no longer life threatening.”
The surgeons removed nearly all of the venous malformation on Lohdodi’s face. Pieces of his tongue, lower lip, left cheek and upper eyelid were removed. A very small amount of malformation, which, if left untreated, would continue to grow, will be removed over the next 18 months, but for now, Waner said, Lahdodi can return to normal activities.

“At this stage, he looks good,” Waner said. 

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