The efficient team used a novel minimally invasive procedure specifically designed for older adults
INVC NEWS
New Delhi,
Life was all good for 74-year-old Naryan (Name Changed) until one fine day he lifted a heavy bucket and started experiencing sudden excruciating pain in the stomach, specifically in the lower abdomen area. The pain was so severe that he had to be rushed to the emergency room at Sakra World Hospital. When an ultrasound was done, nothing showed up surprisingly. Going by the extent of his pain, a contrast CT of the abdomen was conducted.
What came out of the contrast CT was a shocker to the septuagenarian’s family. While his abdomen was alright, the descending thoracic aorta showed a penetrating ulcer. This ulcer is a precursor to the rupturing of the aorta, which, if not treated on time, could be fatal. It was found that Mr Naryan’s blood pressure was already high and as he lifted the heavy bucket, the unbearable pain began which was a sign that his ulcer that was penetrating the aortic wall could make it rupture at any time, causing life threatening damage.
Why was it a unique challenge for the doctors?
According to Dr Deepak Krishnamurthy, Senior Interventional Cardiologist at Sakra World Hospital, Bangalore, a penetrating ulcer of thoracic aorta is not so commonly observed and is rare. Also, it is hard to detect one and is often missed as it does not show up unless a contrast CT is conducted. Also, it generally affects the older adults who are above 60 and mostly seen among the smokers and hypertensives. The worst part of it is if not diagnosed and treated on time, it can result in the rupturing of the aorta leading to death in most cases.
While severe abdominal and back pain are the most common symptoms of this rare condition, it is completely curable if treated on time.
The novel procedure that saved the septuagenarian
The expertise of the team of doctors and the well-equipped facility at the hospital did wonders on the 74-year-old and gave him a fresh lease of life in less than a week’s time. What made that possible? A minimally-invasive novel procedure called Thoracic Aortic Aneurysm (TAA) Stent Grafting that is used to treat abdominal aortic aneurysm, an enlargement of the aorta – the main blood vessel that delivers blood to the body, at the level of the abdomen. This technique is particularly beneficial for the older and more vulnerable patients.
Explaining the procedure, Dr Krishnamurthy says: “We did the procedure under general anesthesia. The CTVS surgeon got us an access through the femoral artery from the groin and then we inserted the Endovascular stent into the aorta to cover the ulcerated area. The stent is a special kind, made of metal mesh covered with PTFE fabric.”
Why was this procedure opted? “It is the least invasive procedure that makes recovery faster and results in shortened hospital stays compared to conventional surgery. It does not require cardio-pulmonary bypass and has lower risk of complications,” says Dr Rocky Katheria, Consultant, Interventional Cardiology at Sakra World Hospital who conducted the procedure along with Dr Krishnamurthy.
While this procedure could be done across all age brackets, it is more appropriate for the older adults. Before conducting the procedure on Mr Naryan, the doctors did a detailed pre-procedure workshop, the patient was kept well-hydrated with IV fluids and the procedure and anesthesia were kept short, owing to his age.
Advantages of TAA Stent Grafting Especially For Older Adults
- TAA Stent Grafting involves a small incision and prevents the need for extracorporeal function – use of heart-lung machine.
- It leads to lesser disruption of the patient’s physiology or vital processes.
- As a result, the patient’s recovery time is quicker and the patient does not require prolonged hospital stays.
- Also, this procedure results in smaller scars.
Following the procedure, Mr. Naryan was kept under normal ICU monitoring and blood pressure control for 24 hours. He was discharged within 6 days of his admission in good health. He is now doing perfectly well with no signs of pain at all and an enhanced quality of life, thanks to the precision of the doctors and the successful minimally-invasive procedure.
