Overview

A long journey from Sundergarh, Orissa, to Kolkata proved life-saving for Mrs R, a 42-year-old homemaker. She was diagnosed with Aortic dissection, a rare condition where one of the layers of the aorta- which is the single-most important blood vessel in the human body supplying blood from the heart to all the organs- gave way and tore apart.

This is a highly fatal condition, where almost a third of the patients don't even get the opportunity to get diagnosed and reach a hospital with expert care on time; among those who do, almost a third do not survive, unfortunately.

Aortic Dissection Procedure | A Success Story

Mrs R had no changes in her daily routine till about a few days ago when she had some shortness of breath on some exertion. Her husband, a pharmacist by profession and attached to a prominent medical college in Cuttack, noticed this too and became concerned. She had no other significant comorbidities and no particular major disease or symptoms. Some initial tests revealed the possibility of a heart ailment and an aortic pathology.

The couple wasted no further time and rushed to NH-Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, for further specialised care. She was carefully examined by and admitted under the care of eminent senior consultant cardiac surgeon Dr Atanu Saha.

About Dr Atanu Saha

Dr Saha has been a prominent and experienced figure in dealing with complex cardiac and aortic diseases needing surgery for quite a long time, and he quickly suspected Mrs R to have an aortic dissection.

Tracing the Journey to Recovery

She underwent a detailed workup, where echocardiography revealed that her heart's chambers had dilated, and ejection fraction, the pumping function, had become 20%, which is less than 1/3rd of the normal. A quick CT scan confirmed our suspicion, and she was found to have 'Stanford Type A' Aortic dissection, where the inside of the aorta had split apart. Thus the blood from the heart kept rushing into a false channel, compromising the eventual blood supply to the body. The aorta had abnormally dilated, the tears had occurred at multiple levels, and the false route in the vessel had extended almost to the lower abdomen.

Mrs R undoubtedly needed immediate surgical repair to cure her ailment. If delayed further, there was a risk of impending rupture and possible death. This surgery was a highly complex procedure, which needed specialised expertise, spanning around 12 hours. The entry tears in the aorta were repaired, and an artificial valve was implanted to prevent aortic leak. She further needed reconstruction of a large portion of the aorta with a prosthetic material involving the portions of the aortic arch, too, from where vessels supplying the brain and upper limbs originated.

Meticulous techniques were needed, including deep hypothermic circulatory arrest, where the body's core temperature is intentionally lowered to about 18 degrees Celsius to help in the surgery. Mrs R had undergone necessary investigations in a fast-paced manner in the hospital, thus minimising the time spent on eventual treatment, which is a crucial factor in the outcome of such vulnerable patients. The surgery under Dr Saha was extremely daunting, and it ended in the wee hours of the night with a successful outcome. She was removed from ventilatory support and gradually recovered without any untoward events after the operation. She was discharged after stabilising her condition fully and ensuring proper recovery.

The care team, lead by Dr Saha, comprised cardiothoracic and vascular surgery residents Dr Abhinaba Sarkar, Dr Unmesh Chakraborty, and physician associates Mr Gopal Sarkar and Mr Anuj Das, along with anaesthetist and intensive care physicians Dr Chandan Mondal and Dr Soumitra Mukherjee and their team, expert nurses and perfusionists.

The surgical and medical challenges aside, all through her stay, Mrs R managed to keep a smiling face and stayed strong to tackle the post-operative stress, which was the key to her returning to a normal life again.

When to Consult a Doctor

You can also get in touch with the expert doctors at Narayana Healthcare based in your city to get immediate attention and medical support during injuries, health disorders or any other health concern.

Written and Published by Dr Atanu Saha