Sahyadri Hospitals achieved a milestone by successfully conducting a complex surgical procedure known as the frozen elephant trunk on a 55-year-old female patient who had been unknowingly living with chronic aortic dissection. The patient, initially without symptoms, shared her recovery journey during a media briefing. After a thorough examination revealed a tear in the main artery of the heart, symptoms of chronic aortic dissection surfaced, causing a significant dilation of the aorta—measuring nearly double its normal size at 60 millimeters, compared to the typical range of 25 to 30 millimeters.
The severity of the condition prompted the medical team, led by Dr. Swapnil Karne, a cardio-thoracic surgeon at Sahyadri Super Speciality Hospital, Deccan Gymkhana, to opt for the frozen elephant trunk procedure. The surgery, conducted during Diwali, involved temporarily halting the patient’s entire circulatory system for approximately 20 minutes while crucial grafts were implanted. To ensure continuous blood supply to the patient’s brain during this circulatory arrest, an antegrade cerebral perfusion technique was employed.
Dr. Swapnil Karne emphasized the team’s focus on meticulous bleeding management, utilizing advanced monitoring techniques and cerebral protection measures to prioritize patient safety. The successful post-operative recovery, marked by the absence of neurological issues, underscored the effectiveness of their approach. Dr. Shantanu Shastri, a cardiac anaesthetist at Sahyadri Super Speciality Hospital, highlighted the comprehensive recovery plan that led to the patient achieving stability within five to six days.
The frozen elephant trunk graft, a crucial component of the procedure, comes at a significant cost. However, it provides a durable solution and serves as a platform for potential future interventions, according to the medical team.
Drawing parallels with another case, the doctors at Sahyadri Hospital shared an example involving a 62-year-old patient with acute aortic dissection, necessitating immediate intervention. In acute cases, where the walls of the aorta are dissected, impacting blood supply to vital organs, time becomes a critical factor. Unlike the recent asymptomatic case treated with the frozen elephant trunk, acute dissection involves replacing only the dissected part of the ascending aorta. The doctors stressed the importance of recognizing and promptly addressing these conditions for successful outcomes.