Kolkata :

Imagine a blood vessel swelling up like a balloon measuring 13 cm in diameter inside your chest. This is what had happened to a 27-year-old patient from Bangladesh, who went through a life-saving surgery to get rid of the football-sized inflammation at a city hospital last week. The complicated surgery was done by putting the patient on a heart-lung machine which didn’t require doctors to open his chest.

The young man had undergone an aortic valve replacement in his country two years ago, following which he developed the life-threatening complication known as aortic aneurysm. The aorta, which is the main vessel originating from the heart that supplies blood to the entire body, had become thin-walled and dilated like a balloon about to burst. The dilated aorta extended from the aortic root to the proximal arch measuring about 13cmx15cm. It made the patient breathless and triggered severe chest pain.

“The CT scan revealed that his aorta had swelled up almost to the size of a football. This was unusual and extremely dangerous. It was probably triggered by a faulty surgery that he had undergone earlier. It required us to reopen his chest without injuring the thin-walled aortic aneurysmal sac, which was adherent to his breast bone. It also required us to repair the arch of the aorta from which the blood vessels to the brain originate. This part of the operation required the temperature of the patient to be brought down to 18°C while his blood circulation was stopped. The procedure had to be completed in less than 20 minutes or else he would have suffered a major brain stroke,” said Kunal Sarkar, chief cardiac surgeon and head of Medica Institute of Cardiac Sciences, who led the surgery.

Aortic aneurysm surgeries are considered to be complicated cardiac procedures since the blood vessel is close to the heart valve and coronary arteries. The surgery, which took six hours, has set the patient on a path of recovery. “Having performed this challenging operation with uncomplicated recovery is a significant achievement,” claimed Sarkar.

The normal size of an aorta is 3 cm. Once it crosses 5 cm, the chances of a repair through surgery start diminishing. In this case, the vessel had reached four times its normal size and a rupture was imminent. Just 10-25% of patients survive a rupture.

source: http://www.timesofindia.indiatimes.com / The Times of India / Home> City> Kolkata / TNN / June 20th, 2014