SIMS Hospital completes first successful hybrid surgeryin India for complex aortic aneurysm

SIMS Hospital completes first Successful
Hybrid Surgeryin India for complex aortic aneurysm

Cardiac surgeons and Cardiologists together performed successful hybrid surgery for a patient from Mumbai

A 47 year old patient who hails from Maharashtra had developed a life threatening condition called dissecting aneurysm of aorta 4 ½ years ago. The largest blood vessel, aorta had burst resulting in reduction of blood supply to the rest of his body. He underwent an emergency surgery at Mumbai where only the torn area of aorta was replaced and was advised that he may need another major surgery later.

After 4 ½ years he developed severe back pain for which he underwent tests in Mumbai and was advised a complex surgery. He enquired at various hospitals in Mumbai and was directed to SIMS hospitals, Vadapalani. At Mumbai, the hospitals declined to perform the surgery as it was considered too risky and they had no prior experience of performing similar surgeries. Moreover such a procedure has not been done in India to refer from.

At SIMS, the Institute for Cardiac and Advanced Aortic disorder (ICAAD) have a dedicated team that’s has one of the maximum experience in the country in dealing with such complex diseasesofthe aorta.

The patient was assessed by the Aortic team headed by Dr. V.V. Bashi, Director – ICAAD, Dr. A.B. Gopalamurugan, Senior Interventional Cardiologist, Dr. Aju Jacob, Senior Cardiac anesthetist. The team spent hours meticulously going through the CT scan images and arrived at a plan to try and get the best outcome for the patient.

In Western countries a readymade graft called frozen elephant trunk graft is used for doing this procedure, which is quite expensive. Moreover in India, this graft is not yet available. However to overcome the difficulty, the team at SIMSundertook the surgery with a modified technique and with an available graft here. They managed to achieve the same result and it was also more cost effective.

Normally a second operation in the same affected area is very challenging and risky. In this operation they decided to adopt a hybrid technique which involves replacing the ascending and arch of aorta with a graft surgically and replacing the descending aorta through an endovascular approach in the same sitting. After opening the chest, the patient was connected to a heart lung machine through two holes in the groin. The patient’s body temperature was then cooled to 15^oC. The blood circulation was stopped for one hour. Then the complex surgical replacement of the graft was undertaken by Dr. Bashi, and the Endograft was completed at the same time by Dr. Gopalamurugan. This operation had to be done in a high-tech operation theatre that has high quality x-ray equipment available. This facility isavailable at SIMS without which one may not be able to undertake this complex hybrid procedure.

Once the procedure was successfully completed, the patient’s body temperature was brought to 37^oC and patient was disconnected from heart lung machine. He had an uneventful recovery and will be getting discharged in a couple of days.

Thanking the medical team at SIMS Mr.Prashant, Said “I would like to thank the entire team at SIMS Hospital Vadapalani Chennai for putting me back on my feet and giving me a new lease of life. I am happy I selected SIMS Hospital for my medical support

The team included Dr. V. V. Bashi, Dr. A. B. Gopalamurugan, Dr. Aju Jacob. Beside these, highly experienced technicians, perfusionists and nurses were involved. The whole operation took about 8 hours. This is the first time in India a hybrid technique was used in a reoperation which included replacement of ascending aorta, Aortic arch, and descending aorta in the same sitting.