Mr. Banerjee, an 80-year-old male, presented with shortness of breath and mild chest pain over several months. He had a history of previous aortic

surgery and had underwent transurethral resection of the prostate as well.

Initial Presentation and Diagnostics:

He was brought to Narayana Hospital RN Tagore Hospital, Kolkata OPD with signs suggesting aortic dissection. Clinical evaluation, blood tests and and Echocardiography confirmed the same. A detailed CT scan of the aorta supported the diagnosis.

Treatment Plan and Surgery:

The patient required replacement of the aortic root, ascending aorta, and aortic arch

using prosthetic grafts under deep hypothermic circulatory arrest, with major part of the surgery being performed at body temperature 20 degrees celsius. Challenges included navigating dense chest adhesions from prior surgeries, maintaining perfusion to protect cerebral and organ functions, and controlling bleeding. The surgery lasted 16 hours.

Post-Surgical Care and Recovery:

Postoperative recovery was complex due to his age and history of previous surgery. Challenges included

recurrent respiratory infections, ventilator dependence, frailty , sepsis and medication involving multiple antibiotics and also included a tracheostomy. The

patient received intensive care involving multidisciplinary teams. Despite battling several bouts of hospital acquired infections, timely antibiotics ensured recovery. He was discharged 56 days post-surgery.

Outcome:

The meticulous surgical intervention and robust postoperative care resulted in a safe

recovery. Mr. Banerjee's resilience and the hospital's comprehensive support were pivotal.

Conclusion:

Timely diagnosis and advanced surgical techniques ensured a successful outcome, demonstrating that even high-risk aged patients can achieve recovery with robust postoperative care and meticulous planning.