Amrita Hospital conducts four rare surgeries in ten days

Dr Praveen Varma CVTS and Dr Kirun Gopal CVTS with patients John S, Subrahmanyan Potti and family members of the patients

Four patients have successfully undergone surgery for repairing Type A aortic dissection at Amrita Institute of Medical Sciences within a span of 10 days. According to an official release, the surgeries were done on the patients after they were referred from other hospitals.

An aortic dissection is a tear in the inner lining of the aorta (the largest artery in the human body which arises from the heart and from which all other blood vessels arise). The tear in the aorta wall occurs just above the aortic valve which separates the heart from the aorta. Blood enters the inner layers of the wall of the aorta through the tear and passes downwards, sometimes all the way to the legs.

Death occurs due to rupture of the aortic wall because of the pressure of the blood, or extension of the tear backwards to the aortic valve causing a leak. Sometimes, the tear can extend to vessels supplying blood to the brain, triggering a brain stroke. ‘Type A’ Aortic dissection is a life-threatening medical emergency. The condition is not very common and many patients die even before reaching the hospital.

Amrita Hospital has a dedicated Centre for Aortic Diseases and Marfan Syndrome to cater to patients with all kinds of aortic diseases. The release quoted Cardiovascular and Thoracic Surgery Associate Professor Dr Kirun Gopal as saying “Type A Aortic dissection has a high mortality chance if not treated surgically, with half the patients dying within 48 hours of the tear occurring in the aorta.

Usually, diagnosis is delayed as the hospitals initially suspect it as a condition of heart attack, acidity or gas. The most common symptom of Type A Aortic dissection is severe chest pain. Diagnosis is by echocardiogram or more definitively, with CT scan of the chest,” he said. Professor Dr Praveen Varma said, “The only effective treatment for type A aortic dissection is surgery.

However, it is a major operation which involves replacing the aortic valve, the aortic root and the ascending aorta and re-implanting the coronary arteries into the graft. The surgery is done using a technique called total circulatory arrest. Last year, Amrita Hospital conducted five acute aortic dissection with no mortality at all. The 10-hour surgery costs about `4 to 5 lakh.