Cardiac surgeons at SIMS Hospital replace aortic arch without opening chest cavity

Chennai, July 9: Cardiac surgeons at SIMS Hospital performed a rare procedure to replace a diseased aortic arch (a portion of the aorta from which key blood vessels emerge) without opening the chest cavity.

The procedure was necessitated as the patient’s aortic arch had developed an aneurysm of about 5.5 cm that resulted in his developing renal failure.

Fifty-three-year-old Kolla Sathyanarayana from Vijayawada had undergone an open heart surgery five years ago for dissection at the aortic root. At that time, cardiothoracic and aortic surgeon V.V. Bashi had repaired the aortic root.

Mr. Sathyanarayana is severely hypertensive and his blood pressure is not under control. “When he underwent the open heart surgery for root damage, we noticed that his aortic arch and the descending aorta were weak but we left it alone as often, the aneurysm develops very slowly. But in one of the subsequent reviews, we noticed that the aneurysm was enlarging significantly. We do not perform surgeries until the aneurysm threatens to rupture the blood vessel,” explained Dr. Bashi.

After two months of assessment doctors decided to do an endovascular procedure, considering that the patient was not fit for an open surgery. Doctors created a 3D image of the diseased aorta and developed a rubber model of the proposed graft.

When the customised graft came from Israel, the surgeons first performed the procedure using the rubber model before the artificial graft was implanted in the patient.

The graft cost Rs. 15 lakh and the rest of the procedure Rs. 5 lakh. The hospital waived some charges for the patient.

The surgery was performed last week and Mr. Sathyanarayana began walking within three days of surgery. He will soon be back to his routine but will be put on pills to regulate his BP.

Dr. Bashi said aneurysm of the aortic arch could be caused by uncontrolled BP, congenital weakness of the aorta or hereditary reasons.