FARIDABAD / June 22, 2023: A 40-year-old man from Gorakhpur suffering from a tear in the aorta, the largest artery in the body that carries blood from the heart to organs and tissues, was successfully operated upon by doctors at Sarvodaya Hospital, Sector-8, Faridabad, saving his life.
For more than ten days leading up to the surgery, the patient Ajay was complaining of severe chest pain that radiated to his back. He also used to get breathless while walking. He visited three well-known hospitals in Delhi-NCR but could not find any relief. Thereafter, Ajay’s family members rushed him to Sarvodaya Hospital, Sector 8, Faridabad, where doctors diagnosed him as suffering from Type A aortic dissection.
Said Dr. Ved Prakash, Sr. Consultant - Cardiothoracic & Vascular Surgery, Sarvodaya Hospital, Sector-8, Faridabad: “Type A aortic dissection is a life-threatening heart condition can arise due to causes like uncontrolled hypertension, atherosclerosis and connective tissue disorders. It is an emergency situation in which the risk of rupture of aorta and patient’s death increases with every hour. In fact, 40-45% of patients are unable to reach a hospital in time, leading to sudden death in absence of treatment. Many people arrive at the hospital late because symptoms of aortic dissection are similar with other diseases, leading to delay in treatment and diagnosis.”
The wall of the aorta consists of inner, middle, and outer layers. Aortic dissection occurs when there is a tear in the inner layer. Through this tear, the blood enters the space between the inner and middle layers, causing them to separate or ‘dissect.’ If the blood goes through the outside aortic wall, aortic dissection is often deadly. The condition is usually seen in elderly people above 60 years of age, so a 40-year-old individual suffering from it was uncommon.
Said Dr. Ved Prakash, who led the surgery: “Upon diagnosis, the patient was immediately taken to the operating theatre, where a team of cardiac surgeons, cardiac anesthetists, and perfusionists conducted the surgery that lasted eight hours. To correct the problem, we did the Bentall procedure. This involved removal of the ascending aorta (initial part of the artery) and aortic valve, temporary removal of the coronary arteries, inserting an artificial aortic graft (tube) with a built-in valve, making two holes in the graft, and re-attaching the coronary arteries.”
He added: “This is a very complex operation that required us to stop the heart while continuing blood supply to the brain through the artery of the arm. Meticulous anastomotic skills are needed for leak-proof cross-connection between the graft and the arteries of the heart. The surgery was specially challenging that the tear in the artery was almost two-weeks old, leading to friable tissue that is easily irritated, making it more prone to inflammation, bleeding, or tearing.”
Said Dr. Ved Prakash: “Despite the risks, the patient’s recovery was quite fast. He was put on ventilator for 15 hours. He started walking on third day after surgery and discharged on post-operative day five. He is required to take blood thinner medication life-long but can lead a normal life now with some restrictions.”
Aortic valve dissection is a complex situation with high mortality risk. Very few hospitals in India are equipped with expertise in its treatments. Patients should not loose precious time in exploring hospitals without advanced cardiac care facilities, like the case with Ajay, as timely intervention has excellent outcomes, Dr. Ved Prakash added.
