Answering the Call: Physician’s Quick Action Saves Life of Best Friend

As an internationally renowned specialist at Baptist Health Miami Cardiac & Vascular Institute, interventional radiologist Ripal Gandhi, M.D., is accustomed to getting phone calls from other doctors who want his opinion on complex cases. But this call was different.

One of his very best friends, Ilan Rzadkowolsky-Raoli, M.D., was on the phone to discuss a life-threatening case. “It was a Wednesday afternoon. He called and said, “I have a pulmonary embolism.’ So I said, ‘Well, tell me about the patient. What’s going on?’’’ Dr. Gandhi recalls. “And he goes, ‘No, I have a pulmonary embolism.’”

Wait, what?

Dr. Raoli, whose practice is based in Plantation and works outside of Baptist Health, had Dr. Gandhi’s attention.

“I said, ‘It’s me,’” Dr. Raoli recounts. “I am the patient.”

What Is an Embolism?

A pulmonary embolism is a sudden blockage in your pulmonary arteries, the blood vessels that carry blood to their lungs. It usually happens when a blood clot in the deep veins of the leg breaks off and travels to the heart through the intricate highway that makes up the circulatory system.

When a person has a pulmonary embolism, the blockage causes issues with blood flow and oxygen levels in the lungs. It can lead to cardiac arrest, arrhythmia, a fluid buildup in the membrane around the lungs, pulmonary hypertension and death of lung tissue.

Abou a third of people with a pulmonary embolism die before they get a diagnosis and treatment, according to the American Lung Association.

Dr. Raoli’s condition was identified through a CT scan as an acute saddle pulmonary embolism, a large blood clot that sits atop or “saddles” the main pulmonary artery where it divides and branches into the left and right lungs. A blockage at this intersection is extremely serious; it causes blood pressure to drop or become unstable, resulting in inadequate blood supply to the entire body. Without quick treatment, it can result in sudden death or damage to the organs, including the brain, heart and kidneys.

A Quick Response

When Dr. Gandhi grasped his friend’s danger, he sprang into action.

“He said I’ll treat you right away and he mobilized transportation for me,” Dr. Raoli says. “I was able to be moved from my hospital to Baptist Hospital with an ambulance. I got there within an hour after diagnosis and I was being treated that evening.”

As it happens, Dr. Raoli is himself a specialist in these kinds of cases. He knew he wanted to be treated by Dr. Gandhi, a trusted friend and expert in the field of medicine they have in common.

“The way that I wanted to be treated was very specific. It’s not a procedure that’s offered everywhere, but it’s a procedure that I’m intimately involved with,” Dr. Raoli says.

Dr. Gandhi performed a minimally invasive pulmonary thrombectomy, in which an image-guided catheter is threaded through the superhighway of the vascular system. It starts from a small incision in the groin and proceeds through the abdomen to the heart in order to reach and the clot and suction it out.

Since this is not open surgery, the patient does not have to be put under general anesthesia. That gave Dr. Raoli the unique opportunity of viewing Dr. Gandhi’s progress in real time on an extra monitor that was set up especially for him.

“He was actually watching the procedure as we’re doing it,” Dr. Gandhi says.

Dr. Gandhi was able to check in with his friend as he carefully aspirated the clot. “At one point, we looked at the angiogram. I said, you know, this is where I would stop, but what do you think?’” Dr. Gandhi says. “So it was a joint decision there.”

Follow-up scans have shown that the clot is gone, Dr. Gandhi says. He is happy his friend, who was a champion swimmer at Harvard, is back to taking regular laps in the pool to stay healthy.

“I feel like a completely new person,” Dr. Raoli says. “I am completely asymptomatic.”

Taking It One Day at a Time

Dr. Raoli is not sure about the source of the embolism, which can be caused by many factors.

“I did have a history of a recent bout with COVID, and that is a vascular disease that can cause clots. I also had had recent back injury that caused me to be immobile for a while, and I had had recent international travel. So, I had multiple risk factors to develop it,” he says. “I think it’s a combination of having the risk factors and having a genetic predisposition that caused this to happen.”

He is grateful for the care he received — not only during the procedure performed by his skilled friend, but by the outstanding team both before and after in a state-of-the-art facility, he says.

“Miami Cardiac & Vascular Institute is at the forefront of new technology, and this is a newer technology. Without it, I would not be sitting here today talking to you from the perspective of a completely cured patient. I would be a patient that is under lifelong care for a lifestyle-limiting disease process,” Dr. Raoli says.

“I’m grateful for the fact that they have competent doctors and competent care, but also that they are at the forefront of medical device technology,” he adds. “This is not offered everywhere, and I’m happy that it is here.”

Putting Everything in Perspective

There’s a certain irony that Dr. Raoli was faced with such a serious condition, Dr. Gandhi says.

“He treats a lot of patients with pulmonary embolism, something that we talk about all the time. And then he actually gets one himself,” Dr. Gandhi says.

The excellent care Dr. Raoli received was the result of more than 30 years of innovation at the Institute, including a commitment to the most advanced technology and a collaborative approach to care among physicians with a wide range of expertise, Dr. Gandhi says.

“We’re really proud of our team, what we have to offer here at Miami Cardiac & Vascular Institute and Baptist Health. We have awesome, awesome physicians who are really sub-specialized and leaders in different areas of disease. We participate in a lot of clinical trials — in the pulmonary embolism space as well as many other spaces,” Dr. Gandhi says. “I think that ultimately results in the best care for the individual patient.”

Dr. Gandhi is very gratified that he and the Institute were able to play a role in saving his friend and preserving his quality of life.

“At the end of the day, I’m just happy that we can go out to dinner, take additional trips together and, you know, be able to sit down, have a drink and have a good time,” Dr. Gandhi says. “If the situation were reversed, I know that he would be there for me every step of the way. I’m just glad to see that he’s doing so well.”