New Lease of life for a Patient with Dissection of the Aorta

Hypertension is the number one risk factor for mortality worldwide. One of the lesser-known life-threatening complications of high blood pressure is Aortic Dissection. It is a potentially fatal condition in which a tear develops in the wall of the Aorta – the main blood vessel supplying blood to the body. It is an extremely rare condition affecting 1 in 1,00,000 people globally, every year.

The Cardiac Sciences team at Narayana Multispecialty Hospital, Jaipur successfully treated one such patient in a two-hour long emergency procedure. 55-year-old Shravan Lal (name changed) was bought into the emergency room at NH Jaipur with complaints of severe abdominal pain & high blood pressure. A CT Scan revealed a Type B Aortic Dissection extending from the chest to the right leg arteries. The inner layer of the aorta had separated away from the middle layer, which created a false channel for the blood to flow in between the two layers. The tear had resulted in compromised blood flow to the abdominal region, as the blood was leaking inside the aorta wall instead of flowing to the intestine and legs.

He has immediately suggested an endovascular treatment and the procedure was performed by a multi-disciplinary team comprising of Dr. Hemant Madan, Sr. Visiting Consultant – Cardiology, Dr. Nikhil Choudhary, Consultant – Cardiology and Dr. Saify Arsiwala, Sr. Consultant – Cardiac Surgery.

Dr. Nikhil Choudhary, Consultant – Interventional Cardiology while talking about the operation said “The patient’s blood pressure surged to 200/100 mmHg which resulted in the tear. Post evaluating all treatment modalities, an endovascular approach was deemed to be the safest & most effective option as surgery could prove life-threatening”.

Dr. Saify Arsiwala helped expose the femoral arteries of the legs. Via the femoral arteries, a catheter was guided inside the aorta. The catheter helped deliver the Aortic Stent Graft which sealed the false channel through which the blood was leaking inside the aorta wall. Once the false channel was sealed off, normal blood flow to the abdominal region resumed. The patient recovered well and was discharged from the hospital in 4 days. This treatment modality is known as Thoracic Endovascular Aortic Repair and is also effective in treating patients with Aortic Aneurysm.

The Right diagnosis is of utmost importance. If a person is wrongly diagnosed or diagnosis is missed, which is quite common, Aortic Dissection can prove fatal. In this case, had the patient not been treated on time, he could have developed intestinal ischemia or gangrene, as the intestine were not getting adequate blood. His other organs like kidneys could also get affected. We are happy that we could successfully treat the patient & gave him a new lease of life.” added Dr. Choudhary.

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