Nagpur: A team led by cardio-thoracic and vascular surgeon from the city, Dr Sameet Pathak, saved life of a 60-year-old critically-ill patient from Amravati by performing surgery for a rare heart defect called as ‘aortic dissection’ in which the aorta, the main blood vessel arising from the heart, gets torn or split into a two-barrel tube.
The patient required replacement of both the damaged aorta and the aortic valve. The patient, when being brought to Nagpur from Amravati, started developing heart failure and had severe chest pain along with very low blood pressure. His kidney and brain were also affected badly. The patient had also developed paralysis of left limbs. “Had the surgery not been done on time, the patient would have died within 48 hours,” Dr Pathak, who performed the surgery at Wockhardt Hospital, told TOI.
The patient, said Dr Pathak, was suffering from ‘Marfan’s syndrome’. It is a hereditary disorder which affects the connective tissue — the fibres that support all organs. People with Marfan’s syndrome are usually tall and thin with disproportionately long arms, legs, fingers and toes. If the aorta, the largest vessel that carries blood from heart to other parts of body, is affected, the condition can become life-threatening.
“Two other persons in this patient’s family had died due to such heart failure. Hence, the family knew how important it was to reach the doctor on time. They brought the patient in a well-equipped cardiac ambulance. Cardiologist Dr Pawan Agrawal from Amravati had accurately detected the fault and referred the patient here on a Sunday,” said Dr Pathak.
The aorta of this patient had split up due to weakening of the connective tissue in the vessel. The aortic valve was also torn. The aorta was replaced by a polyester tube and the valve with an artificial valve with a corrective surgery called as Bentall procedure. The operation lasted eight hours, said Dr Pathak and added that joining the coronary arteries with the aorta was a very challenging task.
“The surgery was very risky but there was no option but to operate immediately. There were chances of the blood vessel not joining while suturing, leading to bleeding,” said Dr Pathak.
In another unique step, the doctor did not close the patient’s chest after the surgery. The sternum was left open for a day. “This was done to check and stop bleeding after the surgery. The chest was closed the next day. The patient was in the ICU for 5-6 days but thereafter he was immediately on his feet,” said Dr Pathak.
The patient needs to be on lifelong blood pressure controlling medication. Rise of BP beyond 150 could prove fatal. The patient also requires to be on low sodium diet to prevent high blood pressure.
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