SSKM performs rare heart surgery on 23-yr-old

Kolkata: In a rare heart surgery, the SSKM Hospital has given a fresh lease of life to a 23-year-old woman from West Midnapore, suffering from critical structural defect in her aorta, the main great vessel coming out of the heart that supplies blood into the whole body.

A team of doctors at the Cardiothoracic Vascular Surgery (CTVS) and Cardio Thoracic Vascular Anaesthesia (CTVA) departments of the SSKM performed the surgery on the patient, Purnima Bera (23) that lasted for nearly eight hours.

The operation was carried out on last Saturday after she was admitted to the hospital.

A resident of Amarda village of Mohanpur in West Midnapore, she was suffering from severe chest pain following which her family members took her to Mohanpur block hospital.

Bera was later shifted to Egra Superspecialty hospital but due to lack of adequate infrastructure she was again transferred back to the city. She was finally brought to the emergency department of the SSKM a few days ago.

The patient was referred to the CTVS department from Cardiology.

It was found that the patient was suffering from Aortic dissection after conducting echocardiography.

CT angiography could not be performed on the patient as her condition deteriorated.

The doctors decided to operate the patient as her chest pain aggravated. She had dissecting aortic aneurysm extending up to iliac arteries (of lower abdomen) and it was circumferential in nature, that is whole aorta was dilated throughout its whole circumference.

A team of doctors from CTVS and CTVA (Cardiothoracic and Vascular Anaesthesia), headed by Dr Santanu Dutta and Dr Shubhendu Mahapatra performed the rare surgery.

Aortic dissection is a serious condition in which there is a tear in the wall of the major artery carrying blood out of the heart (aorta). As the tear extends along the wall of the aorta, blood can flow in between the layers of the blood vessel wall (dissection). This can lead to aortic rupture followed by instantaneous death or decreased blood flow (ischemia) to organs.

Ascending aortic replacement was done with a Dacron synthetic graft using a peripheral artery cannulation technique under cardiopulmorary bypass. Because of this peripheral cannulation technique and due to the extension of the disease, it took nearly nine hours to complete the entire operation.

"Cardiopulmonary bypass continued for nearly four and a half hours with an aortic clamp time of three hours. Hemostasis (arresting bleeding) was one of the major tasks after the successful repairing of the defect. The next challenge was successful weaning from the cardiopulmonary bypass uneventfully after such prolonged bypass time," Dr Kakali Ghosh of CTVA said.

The patient was shifted to the recovery unit. She has been kept under observation in the critical care unit. The post operative care is also equally important in any cardiac surgery, the doctors observed.

Aortic dissection most often happens because of a tear or damage to the inner wall of the aorta.