Mumbai: A team led by Dr Mayuresh Pradhan, Consultant Cardiothoracic Surgeon and consisting Dr Chetan Bhambhure( Cardiologist), Dr Vasudeo( Anaesthetist), Mr Shankar Gupta ( Perfusionist)gave second lease of life to a 22-year-old boy with Aortic Dissection, a rare and serious condition in which a tear occurs in the inner layer of the body’s main artery (aorta) ultimately causing death . Now, the patient has resumed his daily routine after successful treatment.
Vihaan Chopra (name changed) *, a 22-year-old boy working for MNC from Palghar encountered sudden onset neck and back pain which was excruciating and incapacitating. The patient was referred to Dr Chetan Bhambure at Wockhardt Hospital, Mira Road for prompt medical attention. Due to a high index of suspicion, echocardiography was done and this patient was diagnosed to have an Acute Type A Aortic Dissection which was further confirmed on CT Aortogram. Acute Type A Aortic Dissection 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 (breakage of the aorta, the largest artery in the body) which leads to life threatening internal bleeding. The patient was prepared and wheeled in for an emergency surgery under Dr Mayuresh Pradhan. This is a very high-risk operation with the risk of death and stroke(paralysis) being on the higher side.
Dr Mayuresh Pradhan, Consultant Cardiothoracic Surgeon said, “Acute aortic dissection is a much less common cause of chest pain; prevalence estimates are 2 to 3.5 cases per 100,000 person-years. Up to 40% of patients die immediately, and 5% to 20% die during or shortly after surgery. This condition is seen in patients who are above 60. But, it can also happen in younger patients with a connective tissue disorder like Marfan syndrome. It is a genetic disorder due to which the aorta becomes weakened gets enlarged and gets dissected or ruptured. This condition needs to be addressed on an urgent basis as the patient can die.
Dr Vasudeo Utpat skilfully induced the patient with Mr Shankar Gupta already ready with the assembled Cardiopulmonary bypass machine as such patients can collapse on induction.
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.
Dr Pradhan added, “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. So, I urge 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.”
“I was appalled due to that excruciating neck and back pain as I wasn’t able to do my daily chores with ease. Aortic dissection was an unknown entity to my family and even me. We were shocked to learn about my rare diagnosis which is a genetic abnormality. Fortunately, I received timely treatment at Wockhardt Hospital. I have resumed my daily routine after the treatment now,” concluded the patient Vihaan Chopra (name changed) *.