Acute aortic dissection is mostly seen in patients above 60 years, it can also happen in younger people with a connective tissue disorder like Marfan syndrome.
Vihaan Chopra aged 22 experienced a sudden onset of neck and back pain, which was excruciating and incapacitating. On the advice of a doctor in Mumbai, he got echocardiography done, which showed he was suffering from a rare heart condition, called Acute Type A Aortic Dissection. CT Aortogram further confirmed the diagnosis, following which he had to undergo an emergency surgery.
Acute Type A Aortic Dissection is a serious condition in which a tear occurs in the inner layer of the body’s main artery (aorta), which can ultimately lead to death. It is a rare surgical emergency as with every passing hour the mortality or chance of death increases. If not operated on time, there is a chance of sudden death due to aortic rupture which leads to life threatening internal bleeding, said doctors who treated him.
The patient from Palghar was successfully treated at Wockhardt Hospital, Mira Road by a team of doctors led by Dr Mayuresh Pradhan, Consultant Cardiothoracic Surgeon. The team also included Dr Chetan Bhambhure (Cardiologist), Dr Vasudeo (Anaesthetist), and Shankar Gupta (Perfusionist).
It was a very high-risk operation with the risk of death and stroke(paralysis) being on the higher side, they stated.
Up to 40% of acute aortic dissection die immediately
According to Dr Pradhan, acute aortic dissection occurs rarely with estimated prevalence of 2 to 3.5 cases per 100,000 person-years. However, it is a highly fatal condition.
“Up to 40 per cent of patients die immediately, and 5 per cent to 20 per cent die during or shortly after surgery,” the surgeon said.
Dr Pradhan added that while acute aortic dissection is mostly seen in patients above 60 years, it can also happen in younger people. The risk is high in people with a connective tissue disorder like Marfan syndrome, which causes the aorta to become weakened, enlarged and dissected or ruptured.
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Timely diagnosis and treatment saved the patient’s life
Considering the high risk associated with the condition, the surgery was performed using Cardiopulmonary bypass machine.
As it is a risky proposition to directly open the chest without preparation, the Right Femoral artery (artery in the groin) was cannulated for arterial access. The sternum was opened and Bicaval cannulation was done. Cardiopulmonary Bypass established.
Explaining the procedure Dr Pradhan said, “The entire Aortic Root along with Ascending Aorta was replaced under Deep Hypothermic Circulatory Arrest which means the body temperature has to go up to 18 degrees. Here, all the body organs are put to sleep and only the brain is functioning. Bleeding can be vexing in such cases, so the chest had to be kept open overnight and was subsequently closed the following day once the bleeding appeared to have settled. The next day, the patient was weaned off the ventilator, and on the third postoperative day, the patient was shifted to the ward. On Day 6, the patient was discharged in stable condition.” More News
The surgeon urges people with a history of sudden death in the family or history of such incidents in their family to go for regular screening for this rare condition. Home
