A 42-year-old patient came to Doctor Manoj Daga, Cardio Thoracic Surgeon at BM Birla Heart Research Centre, with a tear in the inner layer of the aorta. Medically this is termed as an aortic dissection but for a non-professional it meant that the patient was bleeding into the false layer of the blood vessel with a risk of rupture at any minute.
The aorta is the main blood vessel that supplies blood to the rest of the body and a rupture would lead to immediate death.
The tear for this patient extended up to the head branches and the branches supplying blood to the lower limbs. When the patient arrived at the BM Birla Heart Research Centre, the valve was leaking and the prognosis did not seem very good.
Cases of aortic dissection are very rare. It is relatively more common in colder areas of the world where the blood vessels are subject to sudden fluctuations due to irregular pressure. In the subcontinent, cases of aortic dissection are comparatively rare.
Dr. Daga instantly recognised the acute emergency and took the patient to the operation table immediately. Ideally, the patient should have been operated soon after diagnosis, but the patient reached BM Birla after seven to ten days of diagnosis at another hospital.
After 5-6 hours of surgery, where the aortic valve was changed with a mechanical valve and the entire dissected pipe was also replaced. Head blood vessels had to be implanted to restore normal blood supply to the head vessels. A graft replacement was also done of the entire ascending aorta with a synthetic tube, the aortic arch and the upper part of the descending thoracic aorta. The patient took some time to recover from the post-operative stage after this intense procedure but now his vitals are normal. He has resumed his regular activities.
Dr Daga said, “While an aortic dissection is always an emergency the surgical complications can be reduced if the patient is brought to the hospital within the 1st two hours of the aortic dissection. According to research 90% of patients die within 2-3 days.”
The most visible sign of an aortic dissection is acute and excruciating pain arising from the back and coming to the chest or going towards the back. The pain is similar to a heart attack and in both cases the patient should be rushed to a cardiac care centre without any delay. Cases of aortic dissection are also noticed in patients with uncontrolled blood pressure.