First in India, an Elderly Person Undergoes Complex Surgery for Acute Type-A & Type-B Aortic Dissection at SIMS Hospital, Chennai

For the 1^st time in India, an elderly gentleman underwent a successful surgery for correction of multiple anomalies of Aorta (Acute Type-A Dissection, Leakage in Aortic Valve and A Tear in the Distal end of the Aorta), in a single stage operation, at The Aortic Aneurysm Centre, SIMS Hospital, Chennai.

L-R: Dr. Raju Sivasamy, Vice President, SIMS Hospital, Dr. V. V. Bashi - Director, Institute of Cardiac & Aortic Disorders, (ICAD), SIMS Hospital, A 65 year old Patient, Patients Daughter, Team of Dr. Bashi (back row)

Type-A dissection in the ascending aorta itself is a lethal condition posing challenge to Cardiac Surgeons. When it happens suddenly, majority of the patients do not survive, unless surgical treatment is done in first 48 hours. Additionally treating the leaking aortic valve and the tear in the lower part of the descending aorta was a huge challenge in this case. Currently in most of the centres, only the ascending aorta is rectified for such cases, leaving the other problems to be tackled after 1 or 2 years. But, the surgeons at SIMS corrected all the 3 different parts of the aorta in a single operation that lasted for about 6 hours.

Case Details

A 65 year old gentleman (name withheld) from Coimbatore was admitted to SIMS Hospital with complaints of severe chest pain radiating to the back and abdomen. The pain was very intense over the past one day before the patient came to SIMS for consultation. Upon detailed investigations, he was diagnosed with Acute type A Aortic Dissection along with a leaking aortic valve and a tear in the lower end of the descending aorta. It was a life-threatening condition for the patient that required an emergency surgery. The patient then rushed-in for surgery within half an hour, which is mandatory in such a condition.

Speaking on the complexity of aortic disorders, Dr. V. V. Bashi - Director, Institute of Cardiac & Aortic Disorders (ICAD) at SIMS said, "It is quite challenging to detect aortic conditions preemptively, and detecting 3 conditions in one case would be difficult unless right diagnostic approach is taken. Another challenge for us was to carry-out all the surgical corrections in a single session, that too on an emergency basis."

The patient underwent successful total corrective replacement of the entire diseased aorta with the repair of the aortic valve as a single stage operation and had an uneventful recovery. He is doing well and assuming normal life.

These kind of complex cases are performed only at few elite medical institutes in the world, because it requires superior surgical skills, latest technology and availability of the modern hybrid graft (Thoraflex Graft).

Explaining the uniqueness of surgery, Dr. Bashi said, "The multi-stage surgeries over years leave the patient and family in a state of fear and anxiety due to risk of interim mortality. The single-stage correction of all the problems will give the patient confidence to live a longer and happy life."

Recently, SIMS Hospital had inaugurated India's First Exclusive Centre for Aortic Diseases, to bring focused approach on treatment and management of Aortic Disorders. The centre works towards creating awareness about various aspects of the conditions, like risk factors, advanced treatment modalities etc.

Expressing his excitement over this outstanding surgical feat, Shri. Ravi Pachamoothoo - Chairman, SRM Group, said, "It has always been our endeavour to be at the forefront of medical innovation and healthcare excellence in India. And our legacy of being in the field of education gives us that edge to bring-in new ideas & innovations, developing & mentoring future clinical talents to achieve that objective. We are fortunate to have outstanding doctors like Dr. Bashi, who has his own legacy in the field of Cardiothoracic surgery, especially in the treatment of Aortic Disorders, to lead our young doctors into a bright future."

In India, approximately 3 - 4 lakh people suffer from various types of Aortic Disorders every year; out of which only around 1000 people are getting treated. If the disease can be diagnosed early most of the patients can be treated successfully, with success rate of more than 95%. Very few centers in our country are performing aortic surgeries in large numbers. Dr. Bashi and his team have performed more than 1,500 aortic surgeries which is one of the largest from any country on par with International standards.