COIMBATORE: A heart surgery team at Kovai Medical Center and Hospital in the city has replaced a damaged aortic valve and aorta and also performed a triple coronary artery bypass graft in a complex 10-hour surgery on a 58-year-old man, the hospital has said in a press release.
Ramasamy of Tirupur was brought to the hospital on August 4 with severe back pain. He had undergone kidney transplantation 25 years ago and had been keeping well all these years.
Investigations, including a computerised tomography angiogram, revealed a long tear in the aorta (aortic dissection) starting from the aortic valve and causing severe valve leak. The tear extended up to the base of the artery supplying blood to the right hand and the brain (innominate artery).
Apart from this problem, there were major blocks in three coronary arteries and the kidney function too had deteriorated.
An emergency surgery was done by a team headed by Chief Cardiac Surgeon V. Nandakumar.
The damaged aortic valve and the aorta were replaced with an artificial valve and a tube graft respectively. Three coronary bypass grafts were also done.
Since the tear in the aorta was extending to the root of the artery that supplied blood to the brain, the blood circulation in the entire body had to be stopped for nearly 45 minutes.
With the help of modern circulatory support equipment, the patient's body temperature was brought down from 37 degrees Celsius to 18 degrees Celsius.
During this period the tissue metabolism was maintained at very low level under low temperature.
Blood circulation was restored at the end of the procedure and normal heart beat resumed. The patient, however, did not require dialysis despite the bad condition of the kidneys. The hospital claimed that Mr. Ramasamy was discharged three weeks after the surgery on showing total recovery.
Dr. Nandakumar said the availability of modern facilities for accurate diagnosis, team work and surgical expertise proved crucial in the successful recovery of the patient.
Chairman of the hospital Nalla G. Palaniswami said leaking aortic dissection carried a very high mortality rate and 40 per cent of the patients died before reaching the hospital.
The replacement of aorta and aortic valve, along with triple coronary artery bypass surgery in leaking aortic dissection, in a renal transplant patient was rare, he claimed.
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