Nagpur: A 17-year-old boy who had met with an accident and suffered a rare type of injury in aorta, the largest blood vessel of the heart, got a new lease of life in the city when doctors conducted a skilled minimally invasive procedure on him.
An interesting fact was that the patient was fully awake and conscious through the procedure and talking to doctors when they were fixing a stent graft in his vessel. The surgery was held in Alexis Hospital last month.
Gaurav Mandal, a student from Raipur, was rushed to a local private hospital after the accident. As he was suffering from excruciating chest pain, investigations were done and it was found that there was a severe injury to the aorta. The part of aorta had thinned out which is called ‘pseudo aneurysm’ in medical terms. Pseudo aneurysm of the aortic arch is usually a rare complication after trauma. It is fatal when the rupture occurs from the power of the aortic flow.
The boy was suggested to undergo an open heart surgery. In view of criticality of injury and need for advanced management, his parents shifted him to Alexis Multispeciality Hospital.
Here, interventional cardiologist Dr Rishi Lohiya, interventional radiologist Dr Rajesh Mundada and cardiovascular and thoracic surgeon Dr Puneet Jandial reviewed his condition.
“Traditionally, such aortic injuries are treated with high risk supra major surgery (open heart surgery). However, with new technical advancement, such surgeries can be avoided. So, we decided to opt for the modern technique over the traditional mode of treatment,” said Dr Lohiya.
Gaurav was admitted and treated with endovascular repair of thoracic aorta using a graft stent.
“Endovascular repair is a minimally invasive procedure. It was done with a small cut (incision). As patient was under local anaesthesia, he was fully awake and conscious through the procedure,” said Dr Mundhada.
An endovascular stent graft is a fabric tube supported by metal wire stents (also called a scaffold). It was fixed which reinforced the weak spot in the aorta. The graft sealed the area tightly with artery above and below the aortic aneurysm. This ultimately allowed blood to pass through it without pushing on the aneurysm.
“When we heard of an open heart surgery, me and my parents were quiet nervous. But the confidence and support of doctors helped us go for the advanced technology procedure,” said Gaurav.
After 4 weeks of procedure, a repeat CT scan showed complete healing of the pseudo aneurysm.