Guyana marked a major milestone with the completion of its second brain Arteriovenous Malformation (AVM) removal surgery – which has now left a Police Corporal almost free of the disease.
An AVM is a tangle of abnormal blood vessels connecting arteries and veins in the brain, which causes conditions that can damage brain cells, eventually leading to seizures.
Amit Bacchus, a 35-year-old Police Corporal, underwent the $6 million surgery to remove a large AVM at the Woodlands Hospital.
Bacchus was initially evaluated on November 9, 2019, after he experienced seizures and vomiting. He had suffered an assault to the head a few years ago which resulted in the symptoms.
His diagnosis was confirmed following a CT scan and a Magnetic Resonance Angiography (MRA). The Policeman was subsequently evaluated by neurosurgeon Dr Amarnauth Dukhi, who recommended minimally invasive endovascular embolisation treatment.
The surgery was conducted on January 25, 2022, by Dr Dukhi with the assistance of foreign professionals and a team from the Woodlands Hospital.
At a press briefing on Thursday, Dr Dukhi revealed that he decided to perform the surgery even though there was a high risk of Bacchus losing his life on the operating table.
“A grade 5, an extremely large AVM – when we talk about a grade 5 AVM, we think of that in the border of non-operable, not being able to correct surgically, which are categorised as the grade 6, so this grade 5 he had was bordering the grade 6.
“We decided to operate on him because the risk of him dying from a bleed is extremely high with such a large brain AVM,” Dr Dukhi stated.
With this minimally invasive surgery, about 70 to 75 per cent of the AVM has been removed – giving Bacchus a better chance at survival.
“That procedure by itself is extremely delicate, so what you do in this minimally invasive is canalise a vessel in his thigh that takes a small plastic catheter straight to his brain and we send it straight to his brain and we’re seeing on the computer in the catheterisation lab when you locate the AVM, then you could see,” Dr Dukhi said.
“Locating it we saw an extremely large AVM. Now we organised to use something that you call onyx, Onyx is a first-line treatment formulisation of AVM, it’s a liquid embolic agent that closes off vessels and through that vessel that was canalized we send that tube up to the brain.”
However, that was not the end of the surgery according to Dr Dukhi, who said that “as we glued some of those vessels, we realise the number of vessels and the angle they were in, we would have been able to prevent the closure of normal vessels…and the first time in Guyana, we had to use something you call a brain flow diverter.
“We had to put a temporary catheter in the brain to redivert the normal flow away from the AVM,” he added.
The doctor said that they were hoping to remove the remaining portion of the AVM within the next three to six months.
Bacchus recalled that before surgery he was not able to complete simple tasks such as riding a bike, but now with the surgery, he is back on his feet.
He extended gratitude to all the donors who helped to fund the surgery.
“Thank you to all, I would like to thank God Almighty for seeing me through this surgery, as Dr Dukhi said I had a lot of risk in this surgery. I thank Dr Dukhi and the team at Woodlands Hospital for this surgery as well and for being successful, I would like to thank my beautiful wife who see me through the surgery, I would like to thank the Guyana Police who supported me through this surgery.”
“Since I finished this surgery about a month now, by God’s grace, I’m not just a 100 but I’m a 110 per cent, things that I couldn’t do normally I could do normally now,” the man added.