CHENNAI: Believed to be the first such surgery in India, an aortic arch replacement without open surgery has been carried out at SRM Institute for Medical Science (SIMS) hospital.
“It is a life-threatening operation. Across the world, the operation without open surgery has been done only 16 times before,” said Dr V V Bashi, senior cardiothoracic surgeon and chief of aortic surgery at the press meet today. The arch is one of the main areas of the aorta, the largest blood vessel, that supplies blood to the head, brain and upper limbs.
A 53-year-old patient, Sathyanarayana Kolla, who has been diagnosed with a dissection and aneurysm of aortic arch, a bulge in the portion of the aorta closest to the heart, had approached SIMS hospital from Hyderabad after many doctors had declared open surgery was risky for him.
Endovascular treatment (a keyhole approach), was not done in India before due to lack of availability of grafts and expertise that were needed for the operation. “As everyone’s arch of aorta differs, the grafts can’t be bought readymade,” said Dr A B Gopalamurugan, senior interventional cardiologist and chief of endovascular intervention. The grafts were imported from Israel.
A few days before the surgery, the entire process was done on a trial and error basis with a rubber mould of the patient’s aorta to ensure the feasibility of the patient, they said.
Once Dr Bashi carried out a procedure on the patient’s neck to divert the blood vessels to the brain and head, Dr Gopalamurugan performed the endovasular procedure to replace the arch of aorta with the graft. “If the arch bursts, the person will die within 3 to 4 mins,” said Dr Gopalamurugan. The operation lasted for almost five hours.
As it affects one of the many organs, the symptoms varies with different people. For Sathyanarayana, it led poorer kidney function.