A 64-year-old retired government teacher from Medak district has recovered after undergoing a highly complex cardiac operation for an acute aortic dissection at KIMS Hospitals, Kondapur. The 10-hour procedure required reconstruction of the aortic arch and was performed after the life-threatening condition extended into major blood vessels.
The patient, who had hypertension, initially developed severe chest pain that radiated towards her back. Sweating and vomiting accompanied the pain. A CT scan subsequently identified a dissection involving the ascending aorta and extending into its major branch vessels, prompting her transfer to KIMS Kondapur for specialised care.
The surgical procedure was led by Chief Cardiac Surgeon Dr Nisarga and Chief Cardiologist Dr Ravi Kumar Aluri, along with a multidisciplinary cardiac team. The surgeons replaced the ascending aorta, performed debranching of the innominate artery and re-implanted the left common carotid artery.
A key part of the operation involved lowering the patient’s body temperature to 18°C using profound hypothermia. Her heart was temporarily stopped and circulation was suspended for approximately 30 minutes. This gave the surgeons a bloodless field to reconstruct the aortic arch, while deep cooling was used to help protect the brain during the period without circulation.
Following completion of the reconstruction, the team gradually rewarmed the patient, restarted her heart and restored blood circulation. She reached the ICU with minimal support and was taken off the ventilator within a few hours.
Her recovery progressed without neurological complications. By the next day, she was able to communicate, marking an encouraging early outcome after the extensive procedure.
The operation involved cardiac surgeons, cardiac anaesthesiologists, perfusionists, surgical assistants and ICU specialists, whose coordinated efforts were central to managing the complex emergency.
The case demonstrates the level of specialised surgical and critical-care coordination required when acute aortic disease involves the arch and its major branches.
(Photo courtesy: kimshospitals.com)