Vadodara Based Parul Sevasharm Hospital Successfully Treats Complex Aortic Aneurysm in a Single Day Under Ayushman Bharat Scheme
Talking about the successful implementation, Dr. Sagar Sahita, Cardiovascular & Thoracic Surgeon who performed the procedure with his team, said, This was a complicated condition which could have been life-threatening, the patient had a leaking aortic aneurysm and a major blood vessel coming from the wrong place.
Parul Sevashram Hospital, Vadodara successfully treated a 52-year-old male patient with complex and life threatening aneurysm of the aortic arch with contained rupture and aberrant right subclavian artery. This high risk patient underwent a combined Total Arch Debranching and Thoracic Endovascular Aortic Repair (TEVAR) in a hybrid fashion. Both procedures were performed on the same day.
The patient had severe COVID-19 infection in 2023 with a 15 year history of Hypertension and intracerebral hemorrhage. He had an episode of fainting 2 weeks before admission followed by breathlessness and cough for about 15 days. A medical evaluation found fluid around the lungs, and detailed imaging showed a large aneurysm in the distal arch of the aorta that had developed a leak, with bleeding temporarily contained by surrounding tissues.
Further complexity was introduced by an aberrant right subclavian artery arising from the sac of the aneurysm and passing behind the trachea and esophagus. Because of the seriousness and complexity of the condition, the multidisciplinary team decided to plan and perform two big procedures in one day. This included complete arch debranching to reroute and protect the major blood vessels supplying the brain and upper limbs, followed by TEVAR, where a stent graft was used to seal the diseased portion of the aorta from the inside. The aberrant right subclavian artery was also occluded with a specialized vascular plug.
The unique features of the case were the leaking aortic aneurysm with temporarily contained bleeding, an abnormal origin of the right subclavian artery behind the trachea and esophagus and the need for arch debranching and TEVAR to be performed on the same day.
The procedure is said to be the first such procedure done under the Ayushman Bharat scheme in Gujarat. The successful management of this patient was dependent on close coordination between cardiac surgeon, cardiac anesthetist, pulmonologist, radiologists, intensivists, critical care team and nursing staff.
Talking about the successful implementation, Dr. Sagar Sahita, Cardiovascular & Thoracic Surgeon who performed the procedure with his team, said, “This was a complicated condition which could have been life-threatening, the patient had a leaking aortic aneurysm and a major blood vessel coming from the wrong place. It required meticulous planning, sophisticated imaging, a hybrid operating suite and close collaboration of multiple specialists. The ability to perform both procedures on the same day represents a major advance in the management of this rare condition. Special thanks to Dr Tushar Dhopade for guiding us.”
Dr. Geetika Madan Patel, Medical Director and Trustee, Parul Sevashram Hospital said, “Such complex cases need coordinated expertise and advanced treatment capabilities. “This successful intervention reflects our continued focus on making specialized cardiovascular care accessible to patients.”
The successful management of the case highlights the need for advanced aortic and endovascular treatment facilities in providing complex cardiovascular care to patients from Gujarat and neighboring regions closer home.
