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 15oC. 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 37oC 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.
