Stanley’s vascular surgeons perform two complex aortic repairs in a month

Thirty-four-year-old Parthiban, a farmer from Tiruvarur, was wheeled into Government Stanley Medical College Hospital (SMCH) a day before Pongal after a scan at a private hospital revealed a very large abdominal aortic aneurysm that could rupture. He had initially complained of severe abdominal pain. The aneurysm had extended upwards, pressing against his left lung, affecting his breathing. Taking him up for emergency surgery, vascular surgeons performed a two-stage hybrid aortic repair, in which blood flow to the intestines and kidneys was rerouted in an open surgery followed by the placement of a stent graft to prevent rupture.

Within 25 days of the procedure, the team went on to perform another complex aortic surgery on 45-year-old Kuppammal, who was diagnosed with a large aneurysm in the main chest blood vessel (thoracic aorta) that was leaking internally.

The two complex aortic surgeries demonstrated the availability of advanced vascular care in a government hospital in Tamil Nadu, according to doctors.

K. Elancheralathan, professor and head, Department of Vascular Surgery, SMCH, told reporters on Wednesday that when Mr. Parthiban was brought in, there was complete collapse of his left lung as it was compressed by blood.

“In the two-stage hybrid procedure, we first did a bypass surgery for blood flow to the kidneys and intestines. This was crucial to maintain blood flow to the kidneys, intestines, and liver. Next, we shifted him to the cath lab where a stent graft was placed from the thoracic to abdominal aortic segment through a small groin incision. About eight units of blood were transfused. Aortic aneurysm rupture can be highly fatal. He was under the constant monitoring of anaesthetists for six days, and spent 15 days in the intensive care unit,” he explained.

Ms. Kuppammal, who was undergoing treatment for tuberculosis, had come with complaints of chest pain and was coughing up blood. A scan revealed a rupturing aneurysm in the chest. An emergency stent procedure was taken up in which two small incisions were made in the groin and a stent graft was placed in the thoracic segment to stop the leak, Dr. Elancheralathan said.

Both procedures would usually cost ₹20 lakhs to ₹30 lakhs in private hospitals. At SMCH, the procedures were covered under the Chief Minister’s Comprehensive Health Insurance Scheme. “The stent used for Mr. Parthiban costs eight lakhs, and the hospital administrators ensured that we procured them promptly to save a life,” he said.

He added that they were seeing at least two to three patients with aortic aneurysms in a month, and stressed on the need for healthy lifestyle and food habits.

The team comprised assistant professors of Vascular Surgery T. Rajkumar, V.G. Vikraman and V. Radhakrishna; V.J. Karthik, professor and head, Department of Anaesthesiology, and assistant professor Vijayanand.

Medical Superintendent S. Jothikumar and Resident Medical Officer Vanithamalar were present.