Mumbai: A 22-year-old man 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 – got a new lease of life from doctors at the Wockhardt Hospital in Mira Road. Mr Vihaan Chopra (name changed) was suffering from sudden onset neck and back pain that was excruciating and incapacitating. Due to a high index of suspicion, an echocardiography was done and Mr Chopra was diagnosed with 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 chance of death increases. If not operated upon on time, there is a chance of sudden death due to aortic rupture (breakage of the aorta) which leads to life-threatening internal bleeding. However, the very high-risk procedure can also result in a stroke (paralysis) or even death of the patient.
According to consultant cardiothoracic surgeon Dr Mayuresh Pradhan, acute aortic dissection is a much less common cause of chest pain; prevalence estimates are 2-3.5 cases per 100,000 person-years. Up to 40% of patients die immediately, and 5-20% die during or shortly after surgery. This condition is seen in patients who are above 60 years, but can also occur in younger patients with a connective tissue disorder like Marfan syndrome.
“It is a genetic disorder due to which the aorta becomes weakened, enlarged and gets dissected or ruptured. 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, bicaval cannulation was done and cardiopulmonary bypass established,” Dr Pradhan said.
He added that the entire aortic root, along with ascending aorta was replaced under deep hypothermic circulatory arrest. “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.”
After six days of the surgery, Mr Chopra was discharged in stable condition. “I urge people with a history of sudden death in the family or history of such incidents in their family to get regular screening for this rare condition,” said Dr Pradhan.
Meanwhile, Mr Chopra said the excruciating neck and back pain had inhibited his ability to do daily chores with ease. “The condition was unknown to me and my family. We were shocked to learn about my rare diagnosis which is a genetic abnormality. Fortunately, I received timely treatment at Wockhardt Hospital,” he said, adding that he has now resumed his daily routine.
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