Major 'Chill' Down for Aortic Repair

Surgeons at Global Health City lowered a 56-year-old patient’s blood and body temperature to a frosty 20°C, before they could complete the repair of her torn aorta

Published: 04th May 2015 06:03 AM  |   Last Updated: 04th May 2015 06:03 AM   |  A+A-

Aortic Repair

CHENNAI:Not chilling out when the heat is this bad may be fatal for you, but in the case of this 56-year-old lady from Andhra Pradesh, it might have been curtains. Surgeons at Global Health City had to chill the woman’s blood and also body temperature down to a frosty 20 degrees Celsius before they could complete the repair of her torn aorta — a rip that extended from her chest all the way to the base of her skull. “Repairing her aortic arch couldn’t be done when blood was flowing freely through it so we needed to cool her down using the bypass machine such that there was hardly any blood flow. After 90 minutes, we moved in and rapidly repaired her artery,” said Dr Rahul Chandola, Senior Consultant Cardiac Surgeon, Global Health City.

Aortic Repair1.jpgThe woman had been brought in with severe pain in chest and back and with low BP. Upon further investigations such as ECG and ECHO, it was found that she was suffering from Acute Dissection of Aorta (large fatal tear) with impending rupture.

Mortality in such cases is up to 40-50 per cent and there’s a higher risk of rupture of aorta with sudden death. She was immediately rushed to the operation theatre. Upon opening up her sternum, it was found that the whole of the ascending aorta and arch was torn and full of big clots due to rupture. The big artery supplying the brain and the vital arteries supplying the heart were also torn at multiple places. Her Aortic valve also was significantly damaged.

Considering her past medical history and her compliance to medication, it was decided to perform David’s Valve Sparing Re-Implantation procedure instead of Aortic Valve Replacement. “Most surgeons will just replace the aortic valve and the torn section of the aorta, but because of its metal content, it can significantly lower longevity of life. With this method perfected by Dr Tyrone David, a dacron graft is put around the valve and it is sewed into place. Eventually, the valve will regenerate and become more healthy,” he added. The good part about this surgery is that it does not involved taking anti-coagulant drugs every day.

Subsequently, the procedure was done to replace the root of aorta along with the ascending aorta while repairing her valve. Her blood and body were then cooled to very low temperatures and circulation was stopped. Her torn artery to the head was repaired and hemi arch replacement was done. “We had to be very quick and precise, because any mistake and she would have bled out. Everything went well and she is now back home without a large post-operative medicine list,” he beamed.

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