Two years ago, a 60-year-old Ghanaian man had suffered from a life-threatening heart condition. A bulge in his artery threatened to rupture unless medical action was taken. Thereafter, a surgery in the Philippines helped him restore his active life after a stent was inserted into the artery.
A couple of years later, his condition re-appeared only making it worse for him. “I was coughing incessantly, sometimes this cough even caused small clots of blood to come out. My chest felt very heavy and I was getting more breathless by the hour,” said the 60-year-old patient
At Ruby Hall Clinic’s Department of Cardiology, surgeons had begun doing wonders in this very field. When the Ghanaian resident paid them a visit for his condition, further tests were suggested. Treating surgeon, Dr C.N. Makhale, Interventional Cardiologist, Ruby Hall Clinic said, “We discovered that the patient had suffered from an aortic aneurysm once again – a repeat of what had happened in 2017. In fact, this time it had gone step further and was now presented as an aortic aneurysm with a dissection.”
An aneurysm is a balloon-like bulge in an artery that can be formed in arteries of any size. It occurs when the pressure of blood passing through a part of a weakened artery forcing the vessel to bulge outward.
An aortic dissection is a serious condition in which the inner layer of the aorta tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). If the blood-filled channel ruptures through the outside aortic wall, the condition is often fatal.
Aortic dissection is not common. It affects between 5 and 30 people out of every 1 million each year, and it is most likely to affect older men. Virtually everyone who has an aortic dissection experiences pain – typically sudden, excruciating pain, often described as tearing or ripping, known to act like a time bomb.
Other symptoms may include shortness of breath, sudden difficulty speaking, loss of vision, weakness or paralysis of one side of the body or even something as small as persistent leg pain and difficulty walking.
Dr Dhanesh Kamerkar, Senior Vascular Surgeon, Ruby Hall Clinic said, “Diagnosing aortic dissection requires high precision, as it may mimic other more common conditions that cause chest pain. Prompt diagnosis is key, as it requires emergency evaluation and treatment for optimal chances of survival. Although this condition is rare, if not treated in time, it can indeed turn fatal or even pose severe neurological deficits.”
Dr Rahul Sheth, Vascular Interventional Radiologist, Mumbai commented, “There are two possible surgery methods for aortic dissection repair. The first is standard open-heart surgery which is a conventional technique. The second one is the less-invasive endovascular surgery which is as effective. It entails a host of benefits including faster recovery, shorter hospital stay, no large scars and lesser chances of mortality and morbidity. The patient goes home faster and recovers better.”
Talking about the further course of action for this particular case, Dr Makhale added, “Diagnostic results revealed that the stent that was previously inserted had dislodged from its previous position. Moreover, there was a leak along the side of the old stent graft. An endovasular aneurysm repair done with a catheter through the groin was the best solution. We re-enforced both aneurysms with two stents, one in the aortic arch and the other one below it. Usually, stents last for years together and often hold good through life. Either the second aneurysm or the fact that the patient was overweight, probably triggered the slight collapse of the former stent.”
Dr P.K. Grant, Managing Trustee and Senior Cardiologist, Ruby Hall Clinic concluded, “Over the course of the next few days, the patient’s vitals were back to normal and he is now well on the road to recovery and will be flying back home in a couple of days. This is now one of those many cases that represent a paradigm shift in the heart care space in the country. Throughout the years, we have worked to establish a reputation as leaders in cardiac care, with emphasis on diagnosis, and treatment of all cardiac ailments. Recognising the importance of providing effective and definitive treatment during cardiac emergencies, our hospital has definitely risen to the occasion, every single time.”