A 50-year female presented with complaints of severe pain in the upper back and chest. On evaluation was found to have a dissection of the aorta. Dissection of the aorta is a serious problem. An aortic dissection is a condition that causes sudden and severe pain in the chest, back or belly. It involves the aorta, which is the main blood vessel that comes out of the heart and carries blood to the body. In dissection, there is a tear inside the aorta. With the advancement of therapy, now we are able to manage many cases of aortic dissection by stenting the aorta. In this case, there was a large tear that was extending to the artery supplying blood to the left upper limb.
This case was managed by hybrid repair. Our cardiac surgery team of Dr. A Sharda and Dr. Chandan Kumar Raymohapatra first did carotid to carotid and carotid to left subclavian bypass. These bypass grafts prevented brain stroke and maintain blood supply to the left hand. Then the Cardiology team led by Dr. Anupam Jena put a covered stent inside the aorta to seal the tear. This is a one of its kind hybrid repair of the aorta in Odisha. An untreated dissection of the aorta can create many serious problems as blood gets stuck in the damaged part of the wall – As a result, the body organs, which get their blood from the aorta, might not get enough blood. This can lead to problems such as a heart attack, brain damage, kidney damage, intestinal problems, or not enough blood flow to the legs or arms. If this happens, it is an emergency. The wall of the aorta can burst open – This causes lots of internal bleeding and is an emergency.
Timely treatment in this case prevented all complications. KIMS has pioneered many aspects of Cardiology including the first in Odisha to do Trans-catheter Aortic valve replacement, EPS RFA, Endovascular repair of the Aorta, and many more.