68 year old Gets a New Lease of Life at Wockhardt Hospitals

Doctors at Wockhardt Hospitals,Bangalore led by Dr. Ganeshakrishnan Iyer, Consultant Cardiovascular Surgeon, gave a news lease of life to 68 year old man who was suffering from Chronic Type B Dissection of the Aorta with rupture in the Plura (space around the lung) a condition with high fatality rate. He was returned to normal life after a marathon ten hour surgery to repair the breached aorta.

Sampangi, a retired employee of BHEL, first complained of pain in the chest, back and knee as early as 2003. After, initial treatment at a hospital in the city, he was sent home as the doctors felt that his condition was too risky for surgery. He was normal for a while and then the symptoms resurfaced within a couple of years. Once again he started complaining of pain in the knee, back and chest which his family ignored it initially. As time went by the pain became unbearable and he found it difficult to walk a few steps. He was confined to bed for more than 3 months. Later, he stopped taking solid food because of pain while swallowing.

At this stage he was brought to Wockhardt Hospitals to consult Dr. Ranganath Nayak, Consultant Cardiologist, who diagnosed him with Chronic Type B Dissection of the Aorta with rupture in the Plura. He was loosing blood in the chest (plural cavity) and his lung was compressed necessitating surgery. He was then referred to Dr. Ganeshakrishnan Iyer, Consultant, Cardiovascular Surgeon, Wockhardt Hospitals who performed the surgery.On 7th November 2009 Sampangi underwent the surgery which surgery lasted for more than 10 hours.

“On opening the chest the lung was found to be completely compressed by a thick layer of blood clot. On removal of the blood clot the lung was still not expanding and hence it had to be removed. Subsequently the Aorta was repaired using a left heart bypass where part of the blood is drained from the heart and pumped to the lower body using a heart lung machine in order to supply blood to the lower body while the aorta is repaired.” said Dr. Ganeshakrishnan Iyer.

Post surgery, Sampangi was kept under observation for 3 days and later shifted to the room. He started having solid food the next day and started walking for 5 minutes with minimal help.

“Generally most cases of Aortic Dissection are associated with hypertension (High BP); about 80% of cases occur in patients with a history of High Blood Pressure. According to studies the occurrence of Type B Dissection of the Aorta is about 2.7% to 3.5 % per 100,000 patient-years. The condition is more common in men than women at about 5:1 ratio. Most incidents occur between 60 to 70 years. In women less than 40 years of age 50% of cases occur during pregnancy,” Dr. Iyer added.

The Aorta is the main artery that carries blood to the body. It is made up of three layers, the intima, the media, and the adventitia. During Aortic Dissection the blood penetrates the intima and enters the media layer creating a false lumen (abnormal channel of blood within the wall of the involved artery). Aortic Dissection is caused by tear in the wall of the aorta (between the intima and the media layers).

Aortic Dissection can be classified as type A and B based on the involvement of the ascending aorta or the descending aorta respectively. This condition is extremely serious and there is a high fatality rate even with immediate emergency treatment. If the tear in the aorta goes through all three layers then there is rapid blood loss resulting in 80% mortality. A high percentage of patients die before reaching the Hospital.

Type B Dissection of the Aorta accounts for 40% of all Aortic Dissection and its occurrence is more frequent in the mornings between 6 to 10 am and in the winter season.

Treatment

Aggressive blood pressure control should be initiated immediately. The treatment is targeted to reduce aortic pressure and pulsatile flow.

Type B Dissection is managed initially with aggressive drug therapy. Indications for surgical treatment of type B dissections are aortic rupture (as in the case of Sampangi); severe intractable pain; mesenteric, renal, or limb ischemia; and progression of the dissection. Some of the methods used are

• Replacement of the damaged section with a tube graft
• Insertion of a stent, combined with on-going medical management


About Wockhardt Hospitals Cardiac Care:

A center for excellence in interventional Cardiology and Cardiac Surgeries in the country, it has to its name a history of path-breaking procedures, be it the first-ever Conscious Off Pump Coronary Artery Bypass Surgery and Awake Heart Surgery in India. Collectively Wockhardt group hospitals have now have tremendous experience of performing over 40000 Cardiac Surgeries and 75000 interventional cardiology procedures since its inception. The Institute is a preferred destination for adult and pediatric cardiology and cardiac surgeries. The hospital provides treatment on the entire gamut of cardiac diseases from newborn to adolescent. Dedicated operating rooms and post-operative ICUs with state-of-the-art equipment and experienced staff round the clock are provided to continue excellent care.

For enquiries or consultations with our cardiac specialists,please email us at enquiries@wockhardthospitals.net